某院2013-2015年细菌耐药性监测  

Surveillance of bacterial resistance in a hospital between 2013 and 2015

作　　者：张梅[1] 邹艳[1] 陈丽龙[1] 

机构地区：[1]武警四川总队医院检验科,乐山614000

出　　处：《武警医学》2016年第11期1085-1089,1092,共6页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的调查我院2013-2015年临床分离细菌的菌群分布和耐药情况,为临床经验性用药提供依据。方法收集我院2013-2015年临床分离细菌,将所有细菌分离鉴定到种并进行药敏试验,对结果进行回顾性分析。结果我院耐甲氧西林金黄色葡萄球菌分离率、大肠埃希菌及肺炎克雷伯菌产超广谱β-内酰胺酶分离率和铜绿假单胞菌耐碳青霉烯类的检出率均呈下降趋势。耐甲氧西林凝固酶阴性葡萄球菌检出率和鲍曼不动杆菌耐碳青霉烯类的检出率呈上升趋势。大肠埃希菌对氨苄西林、哌拉西林耐药率较高(>75%),对碳青霉烯类和β-内酰胺/β-内酰胺酶抑制药复合物耐药率较低。肺炎克雷伯菌和阴沟肠杆菌对常用抗菌药物耐药率均较低(<40%)。铜绿假单胞菌对常用抗菌药物耐药率很低(<30%)。鲍曼不动杆菌对除复方新诺明和头孢哌酮/舒巴坦外的药物耐药率均较高(>75%)。凝固酶阴性葡萄球菌耐药性较金黄色葡萄球菌耐药性高。高水平氨基糖苷类耐药的肠球菌检出率低。结论我院2013-2015年主要病原菌以大肠埃希菌、肺炎克雷伯菌、金黄葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌等为主。我院的细菌检出及耐药情况与全国细菌耐药检测网报道有差异。开展耐药监测并及时统计分析本医院的数据对指导临床合理用药、控制和治疗院内感染具有重要意义。Objective To investigate the microbial population distribution of clinically isolated bacteria and drug resistance at our hospital between 2013 and 2015 in order to contribute to clinical experience. Methods The bacteria clinically isolated at our hospital over the past three years were collected. These bacteria were isolated and identified for drug sensitivity tests. The results were ret- rospectively analyzed. Results The collection rate of MRSA, ESBLs of E. coil and K. pneumoniae, and MDRP was in decline while that of MRCNS and pan-drug resistant acinetobacter baumanii was on the increase. The drug resistance rate of E. coil to ampicilin and piperacillin was the highest（ 〉 75% ）, but was the lowest to imipenem and PIP. The drug resistance rate of K. pneumoniae and pneumoniae to common antimicrobial agents was the lowest（ 〈 40% ）. The drug resistance rate of pneumoniae to common antimicrobial agents remained low （ 〈 30% ）. The drug resistance rate of A. baumanii was high except SMI-TMP and sulbaetam and cefoperazone. The drug resistance rate of MRSA was higher than that of MRCNS. The collection rate of high-level amimoglycosides resistance was low. Conclusions During the three years between 2013 and 2015, strains isolated at our hospital were mostly E. coil, K. Pneumoniae, Staphylococcus aureus and A. baumanii. The isolation and drug resistance at our hospital were different from what was reported by the Mohnarin. It＇ s important to collect and analyze the isolation in order to guide clinically rational use of drugs and minimize drug resistance.

关 键 词：细菌 抗菌药物 耐药性监测 

分 类 号：R446.5[医药卫生—诊断学]