瑞金医院北院2013年病原菌分布及耐药性分析  

Surveillance and analysis of bacterial resistance of clinical isolates in Ruijin Hospital North in 2013

作　　者：乔丹[1] 周敏[1] 朱咏臻 王天凯[1] 瞿晨芸 樊绮诗[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院北院检验科,上海201800

出　　处：《中国抗生素杂志》2014年第12期951-955,共5页Chinese Journal of Antibiotics

摘　　要：目的了解2013年上海市嘉定区瑞金医院北院临床分离病原菌分布及细菌耐药状况,为临床诊治提供依据。方法临床分离菌株的鉴定采用VITEK2 Compact或API鉴定板条,药物敏感性试验采用VITEK2 Compact或纸片扩散法(K-B法),用WHONET 5.6软件进行数据统计分析。结果 2013年我院共分离出病原菌770株,其中221株(28.7%)来自门诊患者,549株(71.3%)来自住院患者,革兰阴性杆菌523株,占67.9%,革兰阳性球菌247株,占32.1%。排名前5位的病原菌为:大肠埃希菌(190株)、肺炎克雷伯菌(97株)、铜绿假单胞菌(80株)、表皮葡萄球菌(35株),金黄色葡萄球菌(32株)。药物敏感性试验统计表明:革兰阴性杆菌中,非发酵革兰阴性杆菌整体耐药率较高,其中鲍曼不动杆菌和铜绿假单胞菌对亚胺培南的耐药率分别为22.6%和48.1%。耐甲氧西林金黄色葡萄球菌发现6例。未发现对万古霉素、替加环素和利奈唑胺耐药的葡萄球菌和肠球菌。结论我院临床分离病原菌以革兰阴性杆菌为主,细菌耐药情况较为严重,耐药菌主要分布在重症监护病房等科室,符合国内细菌耐药情况,并具有地区的特点。对临床分离菌株的耐药性监测,有利于控制院内感染。Objective To investigate the distribution and bacterial resistance of clinical pathogens isolated from Ruijin Hospital North in Shanghai Jiading district in 2013, and to provide the basis for clinical diagnosis and treatment. Methods Bacteria from clinical specimen were identified by VITEK2 Compact or API identification panels, and drug sensitivity tests were tested by VITEK2 Compact or disk diffusion method（K-B method）. All data were analyzed by WHONET 5.6 statistical software. Results A total of the 770 strains of bacteria were isolated in 2013, including 221 strains（28.7%） from outpatients, 549 strains（71.3%） from hospitalized patients. And 523 strains of Gram-negative bacilli, accounting for 67.9%, 247 strains of Gram-positive cocci, accounting for 32.1%. The top 5 pathogenic bacteria were Escherichia coli（190 strains）, Klebsiella pneumoniae（ 97 strains）, Pseudomonas aeruginosa（ 80 strains）, Staphylococcus epidermidis（35 strains） and Staphylococcus aureus（32 strains）. The incidences of methicillin- resistant Staphylococcus aureus（MRSA） were found in six cases. No vancomycin, tigecycline and linezolid resistant Staphylococcus and Enterococcus were found. To Gram-negative bacilli, non-fermenting gram-negative isolates showed higher resistance to antibacterial agents than Enterobacteriaceae. The drug resistance rate to imipenem of Acinetobacter baumannii and Pseudomonas aeruginosa were 22.6% and 48.1% respectively. Conclusions Clinical isolated pathogens were Gram negative bacilli. Bacterial resistance is also serious. Drug resistant bacteria were mainly distributed in ICU, consistent with domestic bacterial resistance status, but have regional characteristics. Surveillance of the antimicrobial drug resistance of clinical isolates is very important and effective in control of hospital infection.

关 键 词：细菌耐药性监测 药物敏感性试验 抗生素 

分 类 号：R378[医药卫生—病原生物学]