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目的了解广东省东莞市第五人民医院2014年临床分离菌对常用抗菌药物的耐药情况。方法肺炎链球菌采用法国梅里埃公司的ATB STREP 5药敏板条,流感嗜血杆菌和卡他莫拉菌采用法国梅里埃公司的ATB HAEMO药敏板条进行抗菌药物的敏感性试验,其它细菌采用纸片扩散法(K-B法)进行抗菌药物敏感性试验,以CLSI 2013年版为判断标准,数据分析采用WHONET 5.6软件。结果临床所分离的1 880株细菌中,革兰阴性菌占69.5%(1 307/1 880),革兰阳性菌占30.5%(573/1 880)。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为21.5%(34/158)和78.6%(88/112)。166株肺炎链球菌中青霉素敏感(PSSP)、中介(PISP)和耐药(PRSP)的菌株分别占88.6%(147/166)、10.8%(18/166)和0.6%(1/166)。未检出糖肽类耐药的革兰阳性球菌。肠杆菌科细菌对亚胺培南、美罗培南高度敏感,产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌的检出率分别为54.7%(186/340)、42.3%(80/189)和18.9%(7/37)。鲍曼不动杆菌对所测试抗菌药的耐药率均高于40%。铜绿假单胞菌对所测试的抗菌药物耐药率不高,均低于20%。流感嗜血杆菌和卡他莫拉菌β-内酰胺酶的检出率分别为33.3%(57/171)和93.9%(92/98)。结论定期进行细菌耐药性监测有助于了解细菌及其耐药性的变迁,为临床经验用药和合理用药提供依据。
Objective To understand the resistance of clinical isolates to commonly used antibiotics in the Fifth People’s Hospital of Dongguan City, Guangdong Province in 2014. Methods Streptococcus pneumoniae using the French company MEIERE ATB STREP 5 drug-sensitive strips, Haemophilus influenzae and Moraxella catarrhalis using the French Merrill Lynch ATB HAEMO antimicrobial susceptibility test strip susceptibility tests, other bacteria Antibacterial susceptibility test was conducted by disk diffusion method (KB method). According to the CLSI 2013 version, WHONET 5.6 software was used for data analysis. Results Of the 1880 isolates clinically isolated, Gram-negative bacteria accounted for 69.5% (1 307/1 880) and Gram-positive bacteria accounted for 30.5% (573/1 880). The detection rates of MRSA and MRCNS were 21.5% (34/158) and 78.6% (88/112) respectively. 166 strains of Streptococcus pneumoniae were penicillin sensitive (PSSP), mediator (PISP) and resistant (PRSP) strains accounted for 88.6% (147/166), 10.8% (18/166) and 0.6% (1/166) respectively. No glycopeptide-resistant gram-positive cocci was detected. Enterobacteriaceae were highly sensitive to imipenem and meropenem. The detection rates of Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis with extended-spectrum β-lactamases (ESBLs) were 54.7% (186/340), 42.3% (80/189) and 18.9% (7/37). Acinetobacter baumannii tested the antibacterial drug resistance rates were higher than 40%. Pseudomonas aeruginosa tested antibacterial drug resistance rate is not high, are less than 20%. The detection rates of Haemophilus influenzae and Moraxella catarrhalis were 33.3% (57/171) and 93.9% (92/98), respectively. Conclusion Regular monitoring of bacterial resistance helps to understand the changes of bacteria and their drug resistance and provide the basis for clinical experience and rational drug use.