临床常见病原性细菌对抗生素的耐药性分析

目的了解长春地区部分医院临床分离的致病菌对抗菌药物的耐药情况。方法收集吉林大学中日联谊医院和长春中医药大学附属医院临床分离的致病菌，采用K—B法进行抗生素敏感性试验，参照CLSI2009年版的标准判断结果。结果从这两家医院共分离细菌447株，其中革兰阴性菌353株，占78．9％，革兰阳性菌94株，占21．1％。肠杆菌科细菌对氨苄西林的耐药率在70％以上，对庆大霉素的耐药率超过了50％，但对亚胺培南保持较高的敏感性（耐药率〈5％）。金黄色葡萄球菌和表皮葡萄球菌对红霉素耐药率分别为65．2％和82．1％，对万古霉素的耐药率较低，分别为4．5％和3．6％。非发酵革兰阴性杆菌对头孢他啶的耐药率超过50％，铜绿假单胞菌对氨曲南的耐药率达到了62．9％，对他唑巴坦复合制剂、亚胺培南、美罗培南和阿米卡星较为敏感，而鲍曼不动杆菌对各类抗生素的耐药率都较高。结论细菌对抗生素的耐药性仍表现出增长趋势，加强细菌耐药性的检测，对于指导临床正确、合理使用抗生素，减少耐药菌的产生和传播具有重要意义。

Drug resistance of common pathogenic bacteria to antibiotics

Objective To investigate the drug resistance of clinical pathogenic isolates from hospitals in Changchun.Method Bacterial isolates were collected from both China-Japan Union Hospital of Jilin University and Affiliated Hospital of Changchun University of Chinese Medicine.Antibiotic susceptibility test was carried out using Kirby-Bauer method.The data were analyzed according to CLSI 2009 standards.Result 447 strains were isolated from these two hospitals,353 of which were Gram-negative bacteria,94 were gram-positive.Resistance ratio of Enterobacteriaceae to ampicillin and to gentamycin was >70% and >50%,respectively.Enterobacteriaceae maintained a higher susceptibility to imipenem(resistance ratio,<5%).Staphylococcus aureus and Staphylococcus epidmitis resistant to erythromycin were 65.2% and 82.1%,respectively,and Staphylococcus aureus and Staphylococcus epidmitis showed lower resistance to vancomycin,4.5% and 3.6%,respectively.Non-fermentive gram-negative bacteria exhibited higher resistance to ceftazolin(>50%);the resistance rate of Pseudomonas aruginosa to aztreonam was 62.9%,though sensitive to piperacillin-tazobactam,imipenem,meropenem and amikacin.Acinetobacter baumannii showed high resistance to different antibiotics.Conclusion Bacterial resistance to antibiotics is still increasing.Therefore,it is significant and important to enhance the detection of bacterial resistance and the rational use of antibiotics,and to reduce the generation and dissemination of resistant bacteria.