CAJ | 학술논문

目的：对2013年河北省细菌耐药性监测网(Hebarin)三级甲等成员单位临床分离细菌的菌种分布及对常用抗菌药物的耐药性谱型进行分析。方法回顾性分析2013年 Hebarin 收集细菌药敏试验监测数据,采用 K-B 纸片法或微量肉汤稀释法药敏试验,判断标准按临床实验室标准委员会(clinical an laboratory standard institute,CLSI )2012年版,数据分析采用 WHONET 5.5软件。结果共收集细菌34865株,其中革兰阴性菌26659株,占76.5%；革兰阳性菌8206株,占23.5%。革兰阴性杆菌中前5位的细菌分别为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、阴沟肠杆菌；革兰阳性球菌中前5位的细菌分别为金黄色葡萄球菌、肺炎链球菌、屎肠球菌、表皮葡萄球菌、粪肠球菌。大肠埃希菌和肺炎克雷伯菌中超广谱内酰胺酶(extended-spectrum beta-lactamase,ESBL)的检出率分别为62.4%和37.8%；肠杆菌属、沙雷菌属、枸橼酸菌属对亚胺培南和美罗培南的耐药率小于5%,变形菌属对亚胺培南和美罗培南的耐药率为9.9%、2.7%。金葡菌中甲氧西林耐药株所占比率为50.5%。未发现对利奈唑胺、万古霉素耐药的葡萄球菌属细菌。成人肺炎链球菌对青霉素的耐药率为11.1%,流感嗜血杆菌β内酰胺酶的阳性率为29.6%。结论细菌耐药性是不断变化的,细菌耐药性监测对准确掌握细菌对抗菌药物的耐药动向和耐药性变迁,指导临床合理用药具有重要的意义。
목적：대2013년하북성세균내약성감측망(Hebarin)삼급갑등성원단위림상분리세균적균충분포급대상용항균약물적내약성보형진행분석。방법회고성분석2013년 Hebarin 수집세균약민시험감측수거,채용 K-B 지편법혹미량육탕희석법약민시험,판단표준안림상실험실표준위원회(clinical an laboratory standard institute,CLSI )2012년판,수거분석채용 WHONET 5.5연건。결과공수집세균34865주,기중혁란음성균26659주,점76.5%；혁란양성균8206주,점23.5%。혁란음성간균중전5위적세균분별위대장애희균、동록가단포균、폐염극뢰백균、포만불동간균、음구장간균；혁란양성구균중전5위적세균분별위금황색포도구균、폐염련구균、시장구균、표피포도구균、분장구균。대장애희균화폐염극뢰백균중초엄보내선알매(extended-spectrum beta-lactamase,ESBL)적검출솔분별위62.4%화37.8%；장간균속、사뢰균속、구연산균속대아알배남화미라배남적내약솔소우5%,변형균속대아알배남화미라배남적내약솔위9.9%、2.7%。금포균중갑양서림내약주소점비솔위50.5%。미발현대리내서알、만고매소내약적포도구균속세균。성인폐염련구균대청매소적내약솔위11.1%,류감기혈간균β내선알매적양성솔위29.6%。결론세균내약성시불단변화적,세균내약성감측대준학장악세균대항균약물적내약동향화내약성변천,지도림상합리용약구유중요적의의。
Objective To investigate antimicrobial resistance and pathogen in Hebei Antibacterial Resistance Investigation Net in 2013.Methods Antimicrobial susceptibility test was detected by Kirby-Bauer method or broth dilution test.The results were analyzed according to CLSI 2010 breakpoints.WHONET 5.5 software was used to analyze the data.Results A total of 34 865 clinical isolates were collected in 2013,gram negative bacilli and gram positive cocci accounted for 76.5%,23.5%,respectively.The most common pathogen in gram-negative rod was E.coli,P. aeruginosa,K.pneumoniae,A.baumanii and E.cloacae respectively.The most common pathogen in gram-positive cocci was S.aureus,S.pneumoniae,E.facium,S.E.pidermidis and E.faecalis.The extended-spectrum beta-lactamase (ESBL)rate of E.coli and K.pneumoniae were 62.4% and 7.8% respectively.The resistant rate of E.coli and K.pneumoniae to imipenem were 0.8% and 2.6%,but the resistant rateto meropenem was 0.6% and 3.7%,respectively.The resistant rate of P.aeruginosa to imipenem and meropenem were 35% and 39.2% respectively.The resistant rate of A.baumanii to imipenem and meropenem were 70.9% and 78.2%.Methicillin-resistant strains accounted for an average of 50.5% in S. aureus.No staphylococcal strains were found resistant to vancomycin and linezolid.Resistant rate of streptococcus pneumoniae to penicillin was 11.1%.The positive rates of beta lactamase of Haemophilus influenzae was 29.6%.Conclusion As bacterial resistance is changing constantly,surveillance of antimicrobial agents has important significance in mastering drug resistance trend and evolution for guiding reasonable clinical prescription.