CAJ | 학술논문

目的：了解安徽省铜陵地区临床分离菌耐药状况。方法用Kirby‐Bauer法进行药敏试验，用WHONET5．6软件进行耐药性分析。结果2013年共收集非重复临床分离菌3419株，其中革兰阴性菌占75．9％，革兰阳性菌占24．1％。耐甲氧西林金黄色葡萄球菌（金葡菌）（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）分别占金葡菌和凝固酶阴性葡萄球菌的41．3％和73．5％；M RSA对红霉素、庆大霉素、环丙沙星和利福平等均高度耐药，未见耐万古霉素和替考拉宁葡萄球菌和肠球菌属。大肠埃希菌和肺炎克雷伯菌中产超广谱β内酰胺酶株分别占51．6％和42．8％，对碳青霉烯类耐药的肺炎克雷伯菌检出率较2012年显著升高。铜绿假单胞菌对阿米卡星、哌拉西林‐他唑巴坦、头孢吡肟、环丙沙星和头孢哌酮‐舒巴坦的耐药率均低于20．0％。鲍曼不动杆菌对头孢哌酮‐舒巴坦、米诺环素和阿米卡星的耐药率分别为34．7％、57．0％和58．3％，对其他抗菌药物耐药率均在68．0％以上。结论细菌耐药性仍呈增长趋势，对碳青霉烯类耐药的肺炎克雷伯菌等广泛耐药菌在某些科室内的流行播散对临床构成严重威胁，因此加强医院感染控制，合理使用抗菌药物显得尤为重要。
목적：료해안휘성동릉지구림상분리균내약상황。방법용Kirby‐Bauer법진행약민시험，용WHONET5．6연건진행내약성분석。결과2013년공수집비중복림상분리균3419주，기중혁란음성균점75．9％，혁란양성균점24．1％。내갑양서림금황색포도구균（금포균）（MRSA）화내갑양서림응고매음성포도구균（MRCNS）분별점금포균화응고매음성포도구균적41．3％화73．5％；M RSA대홍매소、경대매소、배병사성화리복평등균고도내약，미견내만고매소화체고랍저포도구균화장구균속。대장애희균화폐염극뢰백균중산초엄보β내선알매주분별점51．6％화42．8％，대탄청매희류내약적폐염극뢰백균검출솔교2012년현저승고。동록가단포균대아미잡성、고랍서림‐타서파탄、두포필우、배병사성화두포고동‐서파탄적내약솔균저우20．0％。포만불동간균대두포고동‐서파탄、미낙배소화아미잡성적내약솔분별위34．7％、57．0％화58．3％，대기타항균약물내약솔균재68．0％이상。결론세균내약성잉정증장추세，대탄청매희류내약적폐염극뢰백균등엄범내약균재모사과실내적류행파산대림상구성엄중위협，인차가강의원감염공제，합리사용항균약물현득우위중요。
Objective To investigate the bacterial resistance profile of clinical isolates collected in Tongling area . Methods Antimicrobial susceptibility test was conducted by Kirby‐Bauer method . All the data were analyzed with WHONET 5 .6 software .Results A total of 3 419 clinical isolates were collected during 2013 ,of which gram negative organisms and gram positive organisms accounted for 75 .9% and 24 .1% .MRSA accounted for 41 .3% of S .aureus and MRCNS accounted for 73 .5% of coagulase negative Staphylococcus ,respectively .MRSA showed higher resistance to gentamicin ,ciprofloxacin , erythromycin and rifampicin . No vancomycin‐ or teicoplanin‐resistant strains of Staphylococcus spp . were found . No vancomycin‐or teicoplanin‐resistant strains of E . f aecalis and E . f aecium were found .About 51 .6% of E .coli isolates and 42 .8% of K . pneumoniae isolates produced extended‐spectrum β‐lactamases (ESBLs ) . The prevalence of imipenem‐ or meropenem‐resistant strains of K . pneumoniae increased significantly .The percentage of P . aeruginosa strains resistant to amikacin ,piperacillin‐tazobactam ,ciprofloxacin ,cefepime and cefoperazone‐sulbactam was lower than 20 .0% .The percentage of A .baumannii strains resistant to cefoperazone‐sulbactam , minocycline and amikacin w as 34 .7% ,57 .0% and 58 .3% , respectively . More than 68 .0 % of A . baumannii strains were resistant to any of the other antibiotics tested . Conclusions The antibiotic resistance is growing in clinical bacterial isolates .The spread of carbapenem‐resistant strains of K . pneumoniae in some departments poses a serious threat to clinical practice .We should pay more attention to resistance surveillance and rational use of antibiotics .