河北邢台市人民医院2017年细菌耐药性监测  

Surveillance of bacterial resistance in Xingtai People's Hospital during 2017

作　　者：任宏涛[1] 时东彦[2] 左江华[1] 刘丹丹 张小冲 蔡永冉 李金龙 Ren Hong-tao;Shi Dong-yan;Zuo Jiang-huaI;Liu Dan-dan;Zhang Xiao-chong;Cai Yong-ran;Li Jin-long(XingTai People's Hospital,XingTai 054031;Department of Laboratory Medicine,the Second Hospital of Hebei Medical University,Shijiazhuang 050000)

机构地区：[1]河北邢台市人民医院检验科,邢台054031 [2]河北医科大学第二医院检验科,石家庄050000

出　　处：《中国抗生素杂志》2019年第2期241-247,共7页Chinese Journal of Antibiotics

摘　　要：目的了解2017年河北邢台市人民医院临床所有分离细菌的分布情况及耐药性监测。方法采用自动化仪器法或纸片扩散法(Kirby-Bauer法)对河北邢台市人民医院在2017年临床分离菌株进行药物敏感实验,参照2016版CLSI标准判定结果,并采用WHONET 5.6软件统计分析。结果 2017年共收集细菌4413株,其中革兰阴性菌3368株,占76.3%。革兰阳性菌1045株,占23.7%。革兰阴性菌数量居前5位的是大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和流感嗜血菌;革兰阳性菌数量居前5位是金黄色葡萄球菌、肺炎链球菌、表皮葡萄球菌、粪肠球菌和溶血葡萄球菌。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的检出率分别是74.9%(716/956)和44.7%(246/550),产ESBL株对测试药物的耐药率均比非产ESBL株高。肠杆菌科细菌对碳青霉烯类抗生素仍高度敏感,耐碳青霉烯类大肠埃希菌和肺炎克雷伯菌的检出率分别是0.8%(8/956)和4.9%(27/550)。耐碳青霉烯类铜绿假单胞菌的检出率是27.7%(146/528)。鲍曼不动杆菌耐碳青霉烯类的检出率是63.2%(275/435)。金黄色葡萄球菌和凝固酶阴性葡萄球菌的甲氧西林耐药株的检出率分别是43.5%和85.0%,甲氧西林耐药株(MRSA和MRCNS)对多数测试药物的耐药率均显著高于甲氧西林敏感株(MSSA和MSCNS),MRSA中有90.7%的菌株对复方磺胺甲噁唑敏感,MRCNS中有93.2%的菌株对阿米卡星敏感,未发现万古霉素和利奈唑胺耐药的菌株。青霉素耐药肺炎链球菌(PRSP)检出率为12.9%。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,为临床合理规范使用抗菌药物提供依据,指导院感管理防控措施的制定和避免耐药菌株的传播流行。Objective To investigate the bacterial distribution and antibiotic resistance profile in Xingtai People's Hospital during 2017. Methods An automated system or the Kirby-Bauer method was used to test the susceptibility of clinical isolates to selected antimicrobial agents. Results were analyzed according to CLSI 2016 breakpoints. The susceptibility data were analyzed using the WHONET 5.6 software. Results A total of 4413 strains of bacteria were collected, of which Gram-negative bacteria accounted for 76.3% (3368/4413) and Gram-positive cocci accounted for 23.7% (1045/4413), respectively. The top five Gram-negative bacteria were E. coli, K. pneumoniae, P. aeruginosa, A. baumannii, and H. influenzae. The top five Gram-positive cocci were S. aureus, S. pneumoniae, E. faecium, E. faecalis and S. hominis. The prevalence of ESBLs-producing strains was 74.9% in E. coli and 44.7% in K. pneumoniae. ESBLs-producting Enterobacteriaceae strains were more resistant than non-ESLBs-producing strains in terms of antibiotic resistance rate. The strains of Enterobacteriaceae were still highly susceptible to carbapenems. The prevalence of carbapenem-resistant strains was 0.8% (8/956) in E. coli isolates and 4.9% (27/550) in K. pneumoniae isolates. The prevalence of carbapenem-resistant strains was 27.7% (146/528) in P. aeruginosa isolates and 63.2% (275/435) in A. baumannii isolates. The overall prevalence of methicillin-resistant strains was 43.5% in S. aureus (MRSA) and 85% in coagulase negative Stretophylococcus (MRCNS), respectively. The resistance rates of methicillin-resistant strains to the most of other antimicrobial agents were much higher than those of methicillin-susceptible strains. However, 90.7% of the MRSA strains were still sensitive to trimethoprim-sulfamethoxazole, while 93.2% of the MRCNS strains were susceptible to amikacin. No staphylococcal strains were found resistant to vancomycin or linezolid. The prevalence of penicillin-resistant S. pneumoniae (PRSP) strains was 12.9%. Conclusion Periodic surveillance of

关 键 词：耐药性监测 抗菌药物 多重耐药菌 

分 类 号：R978[医药卫生—药品]