2015年湘雅三医院临床分离病原菌分布的特点及耐药性分析  

Distribution characteristics and drug resistance of clinically isolated pathogenic bacteria in the Thrid Xiangya Hospital,2015

作　　者：程然[1] 靖杰[1] 伍勇[2] 袁璐[2] 

机构地区：[1]武警湖北总队医院检验科,湖北武汉430061 [2]中南大学湘雅三医院检验科

出　　处：《实用预防医学》2017年第1期109-113,共5页Practical Preventive Medicine

摘　　要：目的了解2015年中南大学湘雅三医院临床病原菌的分布特点和耐药现状,为临床合理使用抗生素提供依据。方法收集中南大学湘雅三医院2015年1-12月临床分离病原菌,使用全自动鉴定系统Vitek-2进行鉴定及药敏试验,以2013年CLSI标准进行结果判读,采用WHONET 5.6软件进行数据分析。结果共收集4 801株非重复细菌,其中革兰阴性菌3 226株(67.19%);革兰阳性菌1 575株(32.81%)。肠杆菌科细菌对酶抑制剂和碳青霉烯类药物敏感率>80%。铜绿假单胞菌、鲍曼不动杆菌对亚胺培南的耐药率分别为41.4%、74.8%。金黄色葡萄球菌、表皮葡萄球菌MRSA检出率分别为70.9%、76.7%,葡萄球菌对β-内酰胺类、大环内酯类和氟喹诺酮类均高度耐药。粪肠球菌对大多数抗生素的敏感性高于屎肠球菌。结论 2015年中南大学湘雅三医院临床病原菌以革兰阴性菌为主,耐药现象十分严重,鲍曼不动杆菌尤甚,应引起高度重视,加强预防医院感染。Objective To investigate the distribution features and antimicrobial resistance profiles of clinical isolates from the Third Xiangya Hospital of Central South University in 2015 so as to provide evidence for rational use of antibiotics in clinical practice. Methods Clinical isolates from the Third Xiangya Hospital of Central South University from January to December, 2015 were collected. Vitek-2 automated microorganism identification system was used to identify the isolates and to test the antimicrobial resistance. All the data were analyzed by WHONET 5.6 software according to CLSI 2013 breakpoints. Results Of the 4,801 isolates collected in this study, Gram negative organisms and Gram positive cocci accounted for 67.19% （3,226/4,801） and 32. 81% （1,575/4,801） respectively. The sensitivity rates of Enterobacteriaceae strains to β-Lactamaseinhibitors and carbapenems were 〉 80%. The resistant rates of Acinetobacter baumannii and Pseudomonas aeruginosa to imipenem were 41.4% and 74.8% respectively. The detection rates of MRSA in Staphylococcus aureus and Staphylococcus epidermidis were 70.9% and 76.7% respectively. Staphylococcus isolates were highly resistant to β-Lactamase inhibitors, macrolides and fluoroquinolones. The sensitivities of Fecal streptococcus to most of antibiotics were higher than those of Enterococcusfaecium. Conclusions Most of the clinical isolates from the Third Xiangya Hospital of Central South University in 2015 are Gram negative bacilli. Bacterial resistance rate is still high, especially in Acinetobacter baumannii isolates; and hence, great attention should be paid to prevention of nosocomial infections.

关 键 词：耐药性监测 抗菌药物 药敏试验 多重耐药菌 

分 类 号：R378[医药卫生—病原生物学]