12家部队医院细菌分布及耐药监测分析
发布时间：2018-08-29 16:36
【摘要】：目的调查不同地区部队医院患者血液、尿液等标本中的细菌分布及耐药情况,为合理使用抗菌药物提供实验室依据。方法收集12家部队医院2006年1-12月临床分离的1099株不重复细菌,采用琼脂稀释法测定抗菌药物对细菌的最低抑菌浓度(MIC),计算MIC50、MIC90,并按美国临床实验室标准化协会(CLSI)2007年标准判断敏感率(S%)、中介率(I%)、耐药率(R%),利用WHONET5.4软件进行分析。纸片法检测超广谱β-内酰胺酶(ESBLs),3-氨基苯酚硼酸(APB)纸片增强法检测AmpC酶。结果共获得革兰阳性菌436株(39.7%),革兰阴性菌663株(60.3%)。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(MRSCN)检出率分别为62%和92%,未发现万古霉素耐药的肠球菌和葡萄球菌。大肠埃希菌(E.coli)、肺炎克雷伯菌产ES-BLs的比率分别为51.1%和45.1%,二者产AmpC酶的比率分别为11.3%和16.2%。血液中E.coli和肺炎克雷伯菌对头孢他啶、阿米卡星、头孢噻肟、头孢西丁和左氧氟沙星的耐药率普遍低于尿液中的相应细菌,而血液中铜绿假单胞菌和不动杆菌对美罗培南、头孢他啶、多黏菌素、米诺环素的耐药率均显著高于尿液中的相应细菌。结论MRSA、MRSCN以及产ESBLs、AmpC酶的耐药细菌在部队医院的发生率较高;自血液和尿液分离的细菌对抗菌药物的耐药性差异较大。
[Abstract]:Objective to investigate the distribution and drug resistance of bacteria in blood and urine of patients in different military hospitals in order to provide laboratory basis for rational use of antimicrobial agents. Methods 1099 clinical isolates from 12 military hospitals from January to December 2006 were collected. Agar dilution method was used to determine the minimum inhibitory concentration (MIC),) of antimicrobial agents against bacteria. MIC50,MIC90, was calculated according to the 2007 (CLSI) standard of American Association of Clinical Laboratory Standardization (Agar). The sensitivity rate (S%), intermediary rate (I%) and drug resistance rate (R%) were determined by WHONET5.4 software. Extended-spectrum 尾 -lactamase (ESBLs) and 3-aminophenol borate (APB) were detected by disk method. AmpC enzyme was detected by (APB) disk enhancement method. Results 436 strains of Gram-positive bacteria (39.7%) and 663 strains of Gram-negative bacteria (60.3%) were obtained. The detectable rates of (MRSCN) in methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococcus were 62% and 92% respectively. Vancomycin resistant Enterococcus and Staphylococcus were not found. The rates of ES-BLs production by Escherichia coli (E.coli) and Klebsiella pneumoniae were 51.1% and 45.1%, respectively. The ratios of AmpC producing enzymes were 11.3% and 16.2%, respectively. The drug resistance rates of E.coli and Klebsiella pneumoniae to ceftazidime, amikacin, cefotaxime, cefoxitin and levofloxacin in blood were generally lower than those in urine, while Pseudomonas aeruginosa and Acinetobacter spp were resistant to meropenem. The drug resistance rates of ceftazidime, polymyxin and minocycline were significantly higher than those of the corresponding bacteria in urine. Conclusion the incidence of MRSA,MRSCN and ESBLs,AmpC enzyme resistant bacteria is higher in military hospitals, and the drug resistance of bacteria isolated from blood and urine is different.
【作者单位】：
【基金】：全军医学科研“十一五”计划面上项目资助课题(06MA294)
【分类号】：R82
[Abstract]:Objective to investigate the distribution and drug resistance of bacteria in blood and urine of patients in different military hospitals in order to provide laboratory basis for rational use of antimicrobial agents. Methods 1099 clinical isolates from 12 military hospitals from January to December 2006 were collected. Agar dilution method was used to determine the minimum inhibitory concentration (MIC),) of antimicrobial agents against bacteria. MIC50,MIC90, was calculated according to the 2007 (CLSI) standard of American Association of Clinical Laboratory Standardization (Agar). The sensitivity rate (S%), intermediary rate (I%) and drug resistance rate (R%) were determined by WHONET5.4 software. Extended-spectrum 尾 -lactamase (ESBLs) and 3-aminophenol borate (APB) were detected by disk method. AmpC enzyme was detected by (APB) disk enhancement method. Results 436 strains of Gram-positive bacteria (39.7%) and 663 strains of Gram-negative bacteria (60.3%) were obtained. The detectable rates of (MRSCN) in methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococcus were 62% and 92% respectively. Vancomycin resistant Enterococcus and Staphylococcus were not found. The rates of ES-BLs production by Escherichia coli (E.coli) and Klebsiella pneumoniae were 51.1% and 45.1%, respectively. The ratios of AmpC producing enzymes were 11.3% and 16.2%, respectively. The drug resistance rates of E.coli and Klebsiella pneumoniae to ceftazidime, amikacin, cefotaxime, cefoxitin and levofloxacin in blood were generally lower than those in urine, while Pseudomonas aeruginosa and Acinetobacter spp were resistant to meropenem. The drug resistance rates of ceftazidime, polymyxin and minocycline were significantly higher than those of the corresponding bacteria in urine. Conclusion the incidence of MRSA,MRSCN and ESBLs,AmpC enzyme resistant bacteria is higher in military hospitals, and the drug resistance of bacteria isolated from blood and urine is different.
【作者单位】：
【基金】：全军医学科研“十一五”计划面上项目资助课题(06MA294)
【分类号】：R82
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