标题：2012年度海口市人民医院细菌耐药性监测

      作者：吴多荣，姚 敏，黄 会，韩小胜，张冬霞，周 望
    (海口市人民医院中南大学湘雅医学院附属海口医院检验科，海南 海口 570208）

      卷次： 2014年25卷7期

      【摘要】 目的 分析海口市人民医院 2012年临床分离细菌对抗菌药物的耐药趋势。方法 用VITEK 2
compact鉴定仪对细菌进行鉴定，采用纸片扩散法（K-B法）、仪器法和E-test法对2012年度临床分离菌株分别进
行药敏试验，结果按CLSI 2012年版标准判读，用WHONET5.6软件进行耐药性分析。结果 2012年共收集非重
复临床分离菌株3746株，其中革兰氏阴性菌占78.8% (2950/4746)，革兰氏阳性菌占21.2% (796/3746)。MRSA和
MRCNS检出率分别为35.4%和69.9%，未发现对万古霉素和利奈唑胺耐药的葡萄球菌和肠球菌。肺炎链球菌中
青霉素耐药株(PRSP)为26.7%。β溶血链球菌对万古霉素、青霉素、氨苄西林和头孢吡肟均高度敏感。大肠埃希
菌和肺炎克雷伯菌中ESBLs阳性率分别为59.0%和35.8%，发现对亚胺培南和美罗培南耐药的大肠埃希菌3株和
肺炎克雷伯菌2株。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为17.6%和14.5%。鲍曼不动杆菌对11
种抗生素的耐药率均在30%以下。左氧氟沙星和复方新诺明对嗜麦芽窄食单胞菌有较好的抗菌活性(耐药率<
10%)。结论 2012年该院分离的细菌主要以革兰氏阴性杆菌为主，临床分离细菌对常用抗菌药物呈不同程度的
耐药，未检出对万古霉素耐药的肠球菌和葡萄球菌，肠杆菌科细菌对碳青霉烯类药物呈较低水平耐药状态，应继
续做好对该类药物的保护。

      【关键词】 细菌；耐药性监测；药敏试验

      【中图分类号】 R37 【文献标识码】 A 【文章编号】 1003—6350（2014）07—0992—05


Bacterial resistance surveillance in Haikou People’s Hospital in 2012.
WU Duo-rong, YAO Min, HUANG Hui, HAN
Xiao-sheng, ZHANG Dong-xia, ZHOU Wang. Department of Clinical Laboratory, HaiKou People's Hospital, the
Affiliated Hospital of Xiangya Medical School of Central South University, Haikou 570208, Hainan, CHINA

【Abstract】 Objective To investigate the resistance of clinical isolates of bacteria in Haikou People's Hospi-
tal in 2012. Methods Bacteria were identified by VITEK 2 compact instrument, and antimicrobial susceptibility test-
ing was carried out by Kirby-Bauer (K-B) method, instrument and E-test. Then the data was analyzed by WHONET
5.6 software according to CLSI 2012 breakpoints. Results Of the 3 746 clinical isolates collected in 2012, gram-neg-
ative bacilli and gram-positive bacilli accounted for 78.8% (2 950/3 746) and 21.2% (796/3746), respectively. The de-
tection rates of the meticillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative Staphylococcus
(MRCNS) were 35.4% and 69.9% . Neither vancomycin nor linezolid resistant isolate was found in Staphylococcus.
The rate of penicillin-resistant Streptococcus pneumoniae (PRSP) was 26.7%. Beta-hemolytic Streptococcus was found
highly sensitive to vancomycin, penicillin, ampicillin and Levofloxacin. ESBLs positive rates of E. coli and K. pneu-
moniae accounted for 59.0% and 35.8%. Three E. coli strains and 2 K. peumoniae isolates were resistant to imipenem
and meropenem. The resistance rate of Pseudomonas aeruginosa to imipenem and meropenem were 17.6% and 14.5%,
respectively. The resistance rates of Acinetobacter baumannii to 11 antibiotics were all below 30%. Stenotrophomonas
maltophilia was sensitive to levofloxacin medicine and Sulfamethoxazole-trmethoprim (drug-resistant rate<10% ).
Conclusion Gram-negative bacilli are the most common isolates in our hospital in 2012. No Vancomycin-resistant
isolates were detected in Enterococci and Staphylococcus. Carbopenems-resistant isolates in Enterobacteriaceae were de-
tected in our surveillance, which should be noted.

      【Key words】 Bacteria; Resistance surveillance; Susceptibility testing