2013—2015年某结核病专科医院常见病原菌分布及耐药监测分析  

Resistance surveillance analysis and distribution of common pathogen in a tuberculosis hospital from 2013 to 2015

作　　者：郭艳玲[1] 班武娟[1] 时广利[1] 杨丽梅[1] 

机构地区：[1]首都医科大学附属北京胸科医院检验科,北京101149

出　　处：《国际检验医学杂志》2017年第11期1473-1476,1479,共5页International Journal of Laboratory Medicine

摘　　要：目的对2013-2015年某结核病专科医院临床分离病原菌进行分析,了解病原菌分布特点及耐药性。方法采用VITEK2-compact检测系统对分离的细菌进行鉴定和药敏实验。采用WHONET5.6软件对细菌鉴定及药敏实验结果进行分析。结果共检出革兰阴性菌2 991株,占90.4%,革兰阳性菌317株,占9.6%。连续3年检出率居前三位的病原菌依次为肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌。2013-2015年,产超广谱β内酰胺酶(ESBLs)大肠埃希菌检出率分别为40.4%、48.2%和38.3%,产ESBLs肺炎克雷伯菌检出率分别为16.9%、8.4%和11.6%。未检出亚安培南耐药大肠埃希菌。肺炎克雷伯菌对亚安培南的耐药率平均为1.6%。甲氧西林耐药金黄色葡萄球菌(MRSA)检出率分别为53.8%、54.3%、42.9%。甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)检出率分别为84.5%、82.7%、85.9%。未检出万古霉素、利奈唑胺、替加环素耐药葡萄球菌。肠球菌对庆大霉素、利奈唑胺、替加环素、万古霉素比较敏感。结论碳青霉烯类抗菌药是抗肠杆菌科细菌最有效药物。万古霉素、利奈唑胺和替加环素是抗葡萄球菌较好的药物。肺炎克雷伯菌、鲍曼不动杆菌检出率逐年上升。需加强耐药监测以控制多药耐药菌的传播。Objective To investigate the distribution pattern and antimicrobial resistance of the clinical isolates of pathogen.Methods The identification and dug susceptibility tests of the isolates from 2013 to 2015were performed by using VITEK2-compact system.The susceptibilities of isolates to antimicrobial agents were analyzed with WHONET 5.6 software.Results A Total of2 991(90.4%)gram-negative bacteria and 317(9.6%)gram-positive bacteria were isolated.Among all of the isolates,the top three pathogens were Klebsiella pneumonia,followed by Pseudomonas aeruginosa and Acinetobacter baumannii.The detection rates of extended-spectrum beta-lactamase(ESBLs)-producing Escherichia coli were 40.4%,48.2% and 38.3% respectively in the three consecutive years,while the detection rates of the ESBLs-producing Klebsiella pneumonia were 16.9%,8.4% and 11.6% respectively.No Escherichia coli resistant to impenem were detected.The resistant rate to impenem of Klebsiella pneumonia was 1.6%.The detection rates of methicillin resistant Staphylococcus aureus(MRSA)and methicillin resistant coagulase-negative staphylococci(MRCNS)in the three years were 53.8%,54.3%,42.9% and 84.5%,82.7%,85.9% respectively.No Staphylococci isolates resistant to linezolid and tigecycline were found.Enterococcus isolates were sensitive to gentamicine,linezolid,tigecycline and vancomycin.Conclusion Carbapenems could remain the best antimicrobials against Enterobacteriaccae.Lnezolid and tigecycline could be effective antimicrobials against Staphylococci isolates.The detection rates of Klebsiella pneumonia and Acinetobacter baumannii increased year by year.The monitoring of drug resistance should be strengthened to control the emergence and spread of multidrug resistant pathogen.

关 键 词：细菌 耐药 监测 

分 类 号：R446.5[医药卫生—诊断学]