2004～2010年武汉同济医院临床分离多重耐药菌株监测分析

目的了解武汉同济医院2004年至2010年临床分离多重耐药菌株的检出情况。方法对临床分离菌株,采用纸片扩散法按统一的方案进行药敏试验。按照CLSI 2009年标准进行判断。结果 2004年至2010年该院耐甲氧西林金葡菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRSCN）的检出率分别在35.6%～63.8%和21.5%～61.4%。2004年至2010年共检出36株耐万古霉素肠球菌（VRE）。大肠埃希菌产ESBLs株检出率在29.6%～81.7%,肺炎克雷伯菌产ESBLs株检出率在36.0%～56.6%,产酸克雷伯产ESBLs株检出率在35.3%～67.4%,奇异变形杆菌产ESBLs株检出率在0～26.2%。自2005年起每年均有泛耐药的铜绿假单胞菌和鲍曼不动杆菌的检出。结论该院2004年至2010年多重耐药菌株呈增多趋势,尤其是VRE和泛耐药的铜绿假单胞菌和鲍曼不动杆菌的出现,给临床治疗带来了严峻挑战。

The surveillance of multi-drug resistance of Tongji hospital during 2004 to 2010

Objective To investigate the occurence of multi-drug resistance strains in Tongji Hospital during 2004 to 2010.Method The bacteria from our hospital during 2004 to 2010 were analyzed.Bacterial susceptibility testing was carried out according to an agreed protocol using Kirby-Bauer method.Resultswere analyzed according to CLSI 2009.Result Methicillin resistant strains in S.aureus(MRSA) and coagulase negative staphylococcus(MRSCN) accounted for 35.6% to 63.8% and 21.5% to 61.4% from 2004 to 2010 respectively.36 strains of Vancomycin-resistant Enterococcus(VRE) were found from 2004 to 2010.About 29.6% to 81.7% of E.coli,36% to 56.6% of K.pneumoniae,35.3% to 67.4% of K.oxytoca and 0 to 26.2% of P.mirabilis isolates were ESBLs-producing strains.The pandrug resistance of P.aeruginosa and A.baumsnnii were found every year since 2005.Conclusion The multi-drug resistance had been getting more serious during 2004 to 2010,especially the emerge of VRE and the pandrug resistance of P.aeruginosa and A.baumsnnii,which is a challenge for clinical management.