论文部分内容阅读
目的了解安徽省铜陵地区临床分离菌株耐药状況。方法收集安徽省铜陵地区6所医院2014年临床分离菌,用纸片扩散法进行药敏试验,用WHONET5.6软件进行耐药性分析。结果2014年共收集非重复临床分离菌4 385株,其中革兰阴性菌占76.1%,革兰阳性菌占23.9%。甲氧西林耐药金黄色葡萄球菌(MRSA)和甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)分别占各自菌种的45.7%和65.6%;MRSA对庆大霉素、环丙沙星、左氧氟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及粪肠球菌,屎肠球菌中出现个别菌株对万古霉素和替考拉宁耐药。肺炎克雷伯菌和大肠埃希菌中产超广谱β内酰胺酶株分別占54.3%和49.4%。铜绿假单胞菌对阿米卡星、哌拉西林-他唑巴坦、头孢吡肟、头孢哌酮-舒巴坦和头孢他啶的耐药率均<22.0%。鲍曼不动杆菌对阿米卡星、头孢哌酮-舒巴坦和米诺环素的耐药率分别为46.9%、42.5%和28.8%,对其他抗菌药物耐药率均≥66.8%。结论该地区临床分离细菌耐药率仍高,多重耐药和广泛耐药菌株的检出对临床抗感染治疗构成严重威胁,因此加强医院感染控制、合理使用抗菌药物显得尤为重要。
Objective To understand the drug resistance of clinical isolates in Tongling, Anhui Province. Methods Clinical isolates from 6 hospitals in Tongling, Anhui Province were collected in 2014 and drug susceptibility test was conducted by disk diffusion method. Drug resistance was analyzed by WHONET5.6 software. Results A total of 4 385 non-repetitive clinical isolates were collected in 2014, of which Gram-negative bacteria accounted for 76.1% and Gram-positive bacteria accounted for 23.9%. Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus (MRCNS) accounted for 45.7% and 65.6% of their respective strains. MRSA had no effect on gentamicin, ciprofloxacin, Levofloxacin and rifampicin, etc. were highly resistant, no vancomycin-resistant and probiotics and Staphylococcus aureus, Enterococcus faecium individual strains of vancomycin and teicoplanin resistance. Klebsiella pneumoniae and Escherichia coli producing extended-spectrum β-lactamase strains accounted for 54.3% and 49.4%. The resistance rates of Pseudomonas aeruginosa to amikacin, piperacillin-tazobactam, cefepime, cefoperazone-sulbactam and ceftazidime were all <22.0%. Acinetobacter baumannii amikacin, cefoperazone - sulbactam and minocycline resistance rates were 46.9%, 42.5% and 28.8%, resistance to other antibiotics were ≥ 66.8%. Conclusions The rate of clinical isolates of bacteria in clinical isolates is still high. The detection of multidrug-resistant and widely drug-resistant strains poses a serious threat to the clinical anti-infective treatment. Therefore, it is particularly important to strengthen the control of nosocomial infections and rational use of antimicrobial agents.