2013年—2016年主要革兰阴性菌的耐药性变迁  

Surveillance of bacterial resistance in clinical isolates of common gram negative during the period from 2013-2016

作　　者：黄加铭 范春梅[1] 黄东红[2] 潘少敏[2] 

机构地区：[1]福建医科大学附属第二医院东海院区,福建泉州362000 [2]福建医科大学附属第二医院,福建泉州362000

出　　处：《基层医学论坛》2017年第25期3331-3333,共3页The Medical Forum

摘　　要：目的分析医院感染常见革兰阴性细菌分布特征及耐药情况。方法 2013年1月—2016年12月用VITEK 2 Compact检测了我院临床标本中分离获得的5 168株革兰阴性细菌的药敏结果,并按美国临床实验室标准委员会2016年判断标准进行判断,用WHONET-5.6软件分析数据。结果 4年间共检出5 168株,前4位是大肠埃希菌(2 140株,41.4%)、铜绿假单胞菌(956株,18.5%)、鲍曼不动杆菌(537株,10.4%)、肺炎克雷伯菌(454株,8.8%)。大肠埃希菌和肺炎克雷伯菌产超广谱β内酰胺酶(ESBLs)株的总检出率分别为51.0%和30.5%,大肠埃希菌和肺炎克雷伯菌对亚胺培南和美罗培南敏感率最高(94.9%~99.6%)。铜绿假单胞菌对大部分抗菌药物的耐药率保持相对稳定的低水平;鲍曼不动杆菌对大部分抗菌药物的耐药率有逐年上升趋势,尤以2016年上升幅度大。结论鲍曼不动杆菌对碳青霉烯类的耐药率呈上升趋势,给临床抗菌感染治疗带来极大挑战,连续性的细菌耐药性监测可以给临床治疗提供依据。Objecive To analyze the distribution and drug-resistance of the common gram-negative bacteria. Methods From January 2013 to December 2016,the resistance of 5168 strains ofcommon gram-negative bacteria isolated from our hospital tocommon antibiotics was determined by VITEK2 Compact accordingtothe guidelines of CLSI 2016. WHONET-5.6 software was used to analyze the data.Results A total of 5168 the Gram-negative strains were isolated from 2010 to 2012,the top four pathogens were Escherichia coli（2140 isolates,41.4%）,Pseudomonas aeruginosa（956 isolates,18.5%）,Acinetobacter baumannii（537 isolates,10.4%）,Klebsiella pneumoniae（454 isolates,8.8%）. The prevalence of ESBLs producing strains was 51.0% in E. coli and 30.5% in K. pneumoniae,isolates on average. E. coli and K. pneumoniae are had highest sensitive rate to Imipenem and Meropenem（94.9%-99.6%）. Resistance of P. aeruginosa remain steady to most antimicrobial agents. The A.baumannii isolates resistance tomost ofantibiotics was increased year byyear,especially in 2016.Conclusion The prevalence of carbapenem-resistant A. baumannii is still increasing. Infection due to carbapenem-resistant strains pose huge challenge for cllinicians,and continuous monitoring distribution and drug-resistance profile of pathogens can provide evidence to clinical antibacterial therapy.

关 键 词：革兰阴性菌 耐药性 抗生素 感染 

分 类 号：R446.5[医药卫生—诊断学]