2009-2014年上海某妇幼保健院分离菌分布特点及耐药性分析  

Distribution and antibiotic resistance profile of the pathogenic isolates in a gynecology and obstetrics hospital during 2009-2014

作　　者：仓艳琴[1] 李美玲[2] 陆庭嫣[3] 吕焱[1] 

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院内科,上海200030 [2]上海交通大学医学院附属国际和平妇幼保健院院感科,上海200030 [3]上海交通大学医学院附属国际和平妇幼保健院检验科,上海200030

出　　处：《中国感染与化疗杂志》2017年第4期404-412,共9页Chinese Journal of Infection and Chemotherapy

摘　　要：目的分析上海交通大学医学院附属国际和平妇幼保健院临床分离菌株分布及对抗菌药物敏感性,为临床合理使用抗菌药物提供科学依据。方法回顾性分析2009-2014年临床分离菌株的分布及其药物敏感性;采用VITEK 2全自动细菌分析仪及其配套鉴定卡进行菌株鉴定与药敏试验,结果按CLSI标准判定。结果 6年共检出分离菌6 393株,排名前3位的分离菌依次为大肠埃希菌(33.6%)、粪肠球菌(19.4%)和无乳链球菌(13.7%)。2009年、2010年、2014年分别检出李斯特菌属8株、1株、10株。自2012年起共检出厌氧菌40株。标本分布主要来自生殖道与宫腔标本,分别占53.7%和21.3%;其次是血液标本,占8.2%,包括静脉血(6.1%)和脐带血(2.2%);手术切口标本165株,占2.6%。宫腔、静脉血标本排名前3位分离菌均为埃希菌属、肠球菌属、链球菌属。切口标本以埃希菌属、肠球菌属、葡萄球菌属为主。脐血标本以链球菌属、埃希菌属、肠球菌属为主。厌氧菌主要分离自血标本,占总厌氧菌的82.5%;单核细胞增生李斯特菌主要分离自静脉血和宫腔。总体上,主要分离菌对临床常用抗菌药物的敏感率变化趋势相对稳定,且对大多数抗菌药物的敏感性均处于较好的水平。结论该院临床分离菌主要以大肠埃希菌、粪肠球菌、无乳链球菌为主,对临床常用抗菌药物的敏感性均较好。耐药菌以ESBL阳性的大肠埃希菌为主,MRSA少见。Objective To analyze the distribution and antimicrobial susceptibility of the pathogenic isolates during 2009-2014 for rational use of clinical antibiotics. Methods The clinical data were reviewed and analyzed retrospectively to examine the distribution and resistance profile of the pathogenic isolates. Strain identification and antimicrobial susceptibility test were conducted by BioMerieux VITEK-2 automatic microbiology analyzer and the associated identification cards. All results were interpreted according to CLSI standards. Results A total of 6 393 strains of pathogenic bacteria were isolated during the six-year period. The top three pathogens were Escherichia cob （33.6 %）, EnWrococcus faecalis （19.4 %）, and Streptococcus agalactiae （13.7 %）. In addition, 8, 1, and 10 strains of Listeria spp. were isolated in 2009, 2010, 2014, respectively. A total of 40 strains of anaerobic bacteria had been isolated since 2012. The isolates were mainly from genital tract （53.7 %） and uterine cavity （21.3 %）, followed by blood stream （8.2 %）, including venous blood samples （6.1%） and umbilical cord blood samples （2.2 %）. There were 165 （2.6 %）cases of surgical site infections. Escherichia, Enterococcus, and Streptococcus were the top three bacteria isolated from both uterine cavity and venous blood samples. The top three bacteria isolated from surgical sites were Escherichia, Enterococcus, and Staphylococcus. The bacteria isolated from umbilical cord blood samples were mostly Streptococcus, Escherichia, and Enterococcus. Anaerobic bacteria were mainly isolated from blood samples, which accounted for 82.5 % of all anaerobic bacteria. Listeria monocytogenes isolates were mainly from venous blood samples or uterine cavity. Overall, the antimicrobial susceptibility profile of the pathogenic isolates was relatively stable during the period from 2009 to 2014. Most antibiotics showed good activity against these isolates. Conclusions The pathogens isolated from this gynecology and obstetrics hospit

关 键 词：细菌分布 抗菌药物 细菌耐药性 妇幼 

分 类 号：R446.5[医药卫生—诊断学]