安徽滁州市第一人民医院2015年临床分离菌的耐药性监测  

Surveillance of antimicrobial resistance in the clinical isolates from Chuzhou First Hospital,Anhui Province in 2015

作　　者：陈玲[1] 谢强[1] 

机构地区：[1]安徽省滁州市第一人民医院检验科,安徽滁州239000

出　　处：《中国感染与化疗杂志》2017年第2期153-158,共6页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解2015年安徽滁州市第一人民医院常见分离菌的临床分布及耐药情况。方法各类临床分离菌采用Micro Scan Walk Away 96 PLUS进行鉴定和药敏试验,采用WHONET5.6软件对数据进行统计分析。结果 2015年共分离病原菌1 499株,其中革兰阳性菌370株,占24.7%;革兰阴性菌1 129株,占75.3%。葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)的检出率分别为37.0%和86.3%。葡萄球菌中未见万古霉素、达托霉素和利奈唑胺耐药株。肠球菌中粪肠球菌对达托霉素、万古霉素和利奈唑胺均敏感,屎肠球菌中检出1株耐万古霉素,检出率为2.8%。肺炎链球菌主要来源于儿科,对青霉素均敏感。大肠埃希菌、克雷伯菌属(肺炎克雷伯菌和产酸克雷伯菌)和奇异变形杆菌产ESBL的检出率分别为52.9%、30.8%和25.0%,产ESBL株对测试药物的耐药率均高于非产ESBL株。铜绿假单胞菌对亚胺培南和美罗培南的耐药率均为29.4%。不动杆菌属(鲍曼不动杆菌占85.5%)对亚胺培南和美罗培南的耐药率分别为63.0%和64.5%。结论 2015年该院分离的革兰阴性杆菌耐药严重,尤其是碳青霉烯类耐药的肠杆菌科细菌检出率较高,应引起重视。Objective To investigate the distribution and antibiotic resistance profile of clinical isolates in 2015 for improving antimicrobial treatment in Chuzhou First Hospital. Methods Bacterial identification and antimicrobial susceptibility testing were performed with MieroScan WalkAway 96 PLUS bacterial identification system. All the data were analyzed by WHONET5.6 software. Results A total of 1 499 clinical isolates were collected during 2015, of which gram positive organisms and gram negative organisms accounted for 24.7 % and 75.3 %, respectively. Prevalence of MRSA among S. aureus was 37.0 % and MRCNS among CNS 86.3 %. All （100%） Staphylococcus and E. faecalis isolates were susceptible to vancomycin, daptomycin and linezolid. About 2.8 % of the E. faecium isolates were resistant to vancomycin. All the Streptococcus pneumoniae isolates were penicillin-susceptible, mainly isolated from children. The prevalence of extended-spectrum beta-lactamases （ESBLs） positive strains was 52.9 % in E. coli, 30.8 % in Klebsiella spp. （K. pneumoniae and K. oxytoca） and 25.0 % in P mirabilis. The ESBLs-positive strains showed higher resistance rate than ESBLs-negative strains to most antibiotics. The percentage of the P aeruginosa isolates resistant to meropenem and imipenem was all 29.4 %. The percentage of the Acinetobacter spp. （A. baumannii accounted for 85.5 %） strains resistant toimipenem and meropenem was 63.0 % and 64.5 %, respectively. Conclusions Antibiotic resistance is still serious in Chuzhou First Hospital in 2015, especially the emerging carbapenem- resistant Enterobacteriaceae, which is of great concern.

关 键 词：细菌耐药性 超广谱13内酰胺酶 碳青霉烯类耐药肠杆菌科细菌 

分 类 号：R446.5[医药卫生—诊断学]