2015年度上海市第一人民医院细菌耐药性分析  

Analysis on drug resistance of pathogens in Shanghai general hospital in 2015

作　　者：张晋[1] 王晓平[2] 刘皋林[3] 徐红冰[3] 

机构地区：[1]宝鸡市中心医院临床药学室,宝鸡721008 [2]上海交通大学附属第一人民医院神经内科,上海200080 [3]上海交通大学附属第一人民医院药剂科,上海200080

出　　处：《世界临床药物》2016年第9期609-615,共7页World Clinical Drug

摘　　要：目的了解上海市第一人民医院2015年度临床分离病原菌的分布特点及其对常用抗菌药物的敏感性和耐药性情况。方法收集2015年1月至12月我院各病区临床采集的血、尿、粪便、痰液、引流物及分泌物等送检样本,对分离细菌进行最低抑菌浓度及超广谱β内酰胺酶(ESBL)检测,依据CLSI 2015版抗菌药物药敏折点标准评价检测结果,统计分析2015年度病原菌分布、构成及耐药情况。结果 2015年度我院临床分离获得的非重复病原菌2 929株,其中革兰阳性菌占33.7%(986/2 929),革兰阴性菌占66.3%(1 943/2 929)。金葡菌和凝固酶阴性葡萄球菌中甲氧西林耐药株的平均检获率分别为55.0%(165/300)和84.3%(156/185),肠球菌属中耐利奈唑胺的肠球菌检获率为2.2%(6/277)。产ESBL肠杆菌科细菌中,肺炎克雷伯菌检获率为26.9%(90/334),大肠埃希菌检获率为61.6%(418/678),碳青霉烯耐药肠杆菌科细菌检获率为1.6%(18/1 121),多重耐药铜绿假单胞菌检获率为4.6%(11/238),多重耐药鲍曼不动杆菌检获率为39.9%(67/168)。结论多重耐药和广泛耐药菌株检获率增多,需加强抗菌药敏检测,合理选择抗菌药物。Objective To investigate the distribution of bacterial isolates from Shanghai general hospital in 2015,and to explore its sensitivity to commonly used antimicrobial agents and drug resistance.Methods The clinical data were collected from the blood,urine,feces,sputum,drainage and discharge inspection samples in our hospital ward from January2015 to December 2015.The minimum inhibitory concentration and extended-spectrum β-lactamase（ESBL） test of the isolated bacteria were detected.The analysis of pathogenic bacteria distribution,composition and drug resistance was based on the CLSI 2015 edition of antimicrobial susceptibility test results.Results There were 2 929 strains of pathogens were isolated and detected in our hospital in 2015,of which the gram-positive bacteria accounted for 33.7%（986/2 929）,the gram-negative bacteria accounted for 66.3%（1 943/2 929）.Methicillin-resistant strains in Staphylococcus aureus（MRSA）and coagulase negative Staphylococcus（MRCNS） accounted for an average of 55.0%（165/300） and 84.3%（156/185）respectively,linezolid resistant Enterococcus accounted for 2.2%（6/277）.The prevalence of ESBLs producing strains were26.9%（90/334） in Klebsiella and 61.6%（418/678） in E.coli spp on average,the 1.6%（18/1 121） E.coli were resistant to carbapenems.There were 4.6%（11/238） extensively-drug resistant strains in Pseudomonas aeruginosa and 39.9%（67/168）extensively-drug resistant strains in Acinetobacter baumannii.Conclusion Since the detection rate of multi-drug resistance and extensively drug-resistant strains are increasing,the enhanced susceptibility test and reasonable use of antibiotics are needed to be strengthened.

关 键 词：细菌耐药性监测 药物敏感性 多重耐药菌 

分 类 号：R515[医药卫生—内科学] R97[医药卫生—临床医学]