目的 了解2011年四川大学华西第二医院临床分离菌对常见抗菌药物的耐药性。 方法 采用法国生物梅里埃公司VITEK 2 COMPACT全自动细菌鉴定药敏仪，以及ATB 手工药敏条检测临床分离菌对各种常用抗菌药物的耐药性，参照CLSI 2011年版标准判定药敏试验结果，并用WHONET5.4软件统计分析。 结果 临床分离的1 692株细菌中，G+菌占28.0%（473/1 692），G?菌占72.0%（1 219/1 692）。分离的前5位病原菌分别为大肠埃希菌、流感嗜血杆菌、肺炎克雷伯菌、肺炎链球菌、金黄色葡萄球菌。耐甲氧西林金黄色葡萄球菌和耐甲氧西林的凝固酶阴性葡萄球菌分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的15.1%（22/146）和76.7%（46/60），未检出万古霉素、利奈唑胺耐药株。屎肠球菌对所测抗菌药物的耐药性显著高于粪肠球菌，对氨苄西林的耐药率分别为95.7%和13.3%，高水平氨基糖苷类抗生素耐药屎肠球菌和粪肠球菌的耐药率分别为82.6%和30.0%，检出1株对万古霉素耐药的屎肠球菌，未发现对利奈唑胺耐药菌株。青霉素耐药的肺炎链球菌占4.0%（6/151），肺炎链球菌对红霉素、克林霉素、四环素、复方磺胺的耐药率均高于90%。流感嗜血杆菌、副流感嗜血杆菌以及卡他布兰汉菌产β内酰胺酶的比例分别为58.1%（175/301）、70.0%（21/30）、75.9%（22/29）。肠杆菌细菌中产超广谱β内酰胺酶的大肠埃希菌和肺炎克雷伯菌检出率分别为59.9%和74.1%，耐药率最低的分别是3种碳青酶烯类抗生素和阿米卡星。不发酵糖G?杆菌在分离病原菌中所占比例较低，为12.1%（148/1 692），主要为鲍曼不动杆菌和铜绿假单胞，药敏结果显示，除铜绿假单胞对复方磺胺耐药率为93.5%和鲍曼不动杆菌对氨曲南耐药率为38.9%外，该两种细菌对所测抗生素敏感性高，均在80%以上，未检出泛耐药细菌。 结论 定期进行细菌耐药性监测有助于了解医院细菌耐药性变迁，对指导医院合理应用抗菌药物有重要意义。
Objective To investigate the antibiotic resistance and their genetic homology of stenotrophomonas maltophilia isolated from January 2005 to February 2006 at intensive care unit（ICU） of 6 hospitals in Bejing area.Methods The minimal inhibitory concentration（MIC） of 12 antibiotics against 82 strenotrophomonas maltophilia was determined by broth dilution method.PFGE was used to analyze the homology of 82 stenotrophomonas maltophilia.Results The drug sensitivity tests in vitro showed these strains were resistance to commonly-used antibiotics.Antibiotics with sensitive rate over 50% included Doxycycline, gatifloxacin,cefoperazone-sulbactam,levofloxacin,Compound sulfamethoxazole,Ceftazidime and ticarcillin- clavulanate. 7-18 DNA bands of different size were present in the gel and different homology was shown among the 82 strains.Four couples with homology over 85% were isolated from the same ICU.Three strain were same clones in PLA General Hospitals first hospital.2 couples from the different wards had homology of 80.6% and 79.6% of，respictively.Others strains had either poor or no homology.Conclusions No clonal outbreak is certified at ICU of 6 hospitals in Beijing area. There are only vertical dissemination of single clone in 6 ICU wards.PFGE is an effective approach for drug resistance test and epidemic analysis.
目的 了解呼吸机相关性肺炎（VAP）患者病原菌情况，探讨其细菌耐药性及治疗策略。 方法 通过查阅2008年1月－2009年12月呼吸与危重症医学科收治的128例VAP患者的病历资料，分析其肺部感染病原菌分布特点及耐药率。 结果 VAP平均发病时间为机械通气后5.8 d，总病死率为35.1%（45/128）。共分离出病原菌262株，其中G?杆菌210株（占80.2%），G+球菌38株（占14.5%），真菌14株（占5.3%）。G?杆菌中占前3位的分别是鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷白杆菌，对青霉素类、头孢菌素类抗菌药物高度耐药，而对亚胺培南等耐药率相对较低；G+球菌主要是金黄色葡萄球菌，其中耐甲氧西林的金黄色葡萄球菌对多种常见抗菌药物高度耐药，而对万古霉素敏感。 结论 VAP的主要病原菌为G?杆菌，常为多重耐药的致病菌，应根据药敏结果选用合理的抗菌药物。
Objective To explore the value of chemosensitivity assay in vitro on breast cancer. Methods In vitro chemosensitivity of 6 species of chemotherapeutic agents applied to 38 cases of breast cancer patients were detected by tissue culture-end point staining-computer image analysis (TECIA). Results The sensitivity to chemotherapeutic agents commonly used in the breast cancer level from high to low was as follow: Doxorubicin (ADM), Paclitaxel (TAX), Vinorelbine (NVB), Cyclophosphamide (CTX), Cisplatin (DDP) and Fluorouracil (FU). Conclusion Drugs sensitivity experiment of cancer in vitro by TECIA has an important value to instruct clinical medication and individual chemotherapy for breast cancer.