论文部分内容阅读
目的：了解2014年抚州市第一人民医院临床分离菌对抗菌药的耐药性。方法用ATB reader半自动仪器比色法进行菌种鉴定和药敏试验，参照临床实验室标准化协会（CLSI）2014年版判读结果，WHONET 5.5软件进行数据分析。结果2014年共收集非重复临床分离菌885株，其中革兰氏阴性菌529株（59.8％），革兰氏阳性菌263株（29.7％），真菌93株（10.5％）。大肠埃希菌和克雷伯菌属细菌（肺炎克雷伯菌和产酸克雷伯菌）中超广谱β内酰胺酶（ ESBLs）的检出率分别为36.3％和19.3％，肠杆菌科细菌对美罗培南和亚胺培南的耐药率均低于10％。铜绿假单胞菌对亚胺培南的耐药率为17.0％，鲍曼不动杆菌除对多黏菌素E耐药率＜10％外，对其他常用抗菌药的耐药率均大于50％，多重耐药鲍曼不动杆菌的检出率为75.9％。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）分别占各自菌株的63.0％和71.4％。未发现对万古霉素耐药的葡萄球菌，检测出1株屎肠球菌对万古霉素耐药。结论我院临床分离菌以革兰氏阴性杆菌为主，细菌耐药性仍是临床重要问题，尤其是MRSA的检出率高于国内其他地区，应引起临床高度重视。“,”Objective To investigate the antimicrobial resistance of clini-cal isolates in Fuzhou First People′s Hospital during 2014.Methods The identification and antimicrobial susceptibilities of these isolates both employed the ATB reader semi automatic equipment by colorimetric method.The interpretation of results refer to the CLSI 2013.All data were analyzed by WHONET 5.5 software.Results A total of 885 non-duplicate clinical isolates were collected during 2014.Including gram-negative bacterias ( 529, 59.8%), gram -positive bacterias ( 263, 29.7%) and fungus ( 93 , 10.5%).The prevalence of ESBLs was 36.3%in Escherichia coli and and 19.3%in Klebsiella spp.( Klebsiella pneumoniae and Klebsiella oxytoca ) . The drug resistance of Enterobacteriaceae bacteria to meropenem and imipenem were less than 10%.Drug resistance rate of imipenem was 17% in Pseudomonas aeruginosa isolates,The resistance rates to all the drug tested were greater than 50%in Acinetobacter baumannii strains except for polymyxin E ( less than 10%) .The detection rate of multi -drug resistance Acinetobacter baumannii was 75.9%.The prevalence of MRSA and MRCNS was 63%and 71.4% in respectively each strain, no vancomycin resistant Staphylococcus aureus was found, 1 identified Enterococcus faecium was resistant to vancomycin.Conclusion The majority of clinical isolates inour hospital were gram-negative bacilli, bacterial resistance remains a clinical important problem in, particularly of the detection rate of MRSA was higher than that of other regions in China, which should be concerned high attention.