2013-2015年陕西省第二人民医院细菌耐药监测分析  

Surveillance of bacterial drug resistance of clinical isolates in Second People's Hospital of Shaanxi province,2013-2015

作　　者：殷娟 刘媛[3] 贾晶晶[2] 慕彩妮 赵梅英[2] 王安辉[1] 

机构地区：[1]第四军医大学预防医学系,陕西西安710032 [2]陕西省第二人民医院检验科,陕西西安710005 [3]西安通信学院门诊部,陕西西安710106

出　　处：《现代预防医学》2017年第23期4402-4406,共5页Modern Preventive Medicine

基　　金：陕西省社发公关项目(2016SF-086)

摘　　要：目的了解某医院临床分离病原菌特点及耐药情况,为临床抗菌药物使用提供依据。方法对该院2013-2015临床分离病原菌及耐药情况进行分析。结果 8 354送检样本中分离1 439株病原菌,其中革兰阳性菌247株(17.2%),革兰阴性菌1 192株(82.8%)。前5位病原菌为大肠埃希菌(23.8%)、肺炎克雷伯菌(14.5%)、鲍曼不动杆菌(13.3%)、铜绿假单胞菌(12.7%)和金黄色葡萄球菌(11.6%)。金黄色葡萄球菌167株中耐甲氧西林金黄色葡萄球菌占53.3%(89/167)。肠杆菌科细菌较敏感抗菌药物为头孢哌酮/舒巴坦和亚胺培南。金黄色葡萄球菌对青霉素、红霉素耐药率较高,未发现耐万古霉素的菌株。鲍曼不动杆菌对常见抗菌药物的耐药率均大于85%,明显高于铜绿假单胞菌(P<0.05);铜绿假单胞菌敏感性较高的抗菌药物有哌拉西林、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦和妥布霉素。结论该医院临床分离病原菌以革兰阴性杆菌为主,大肠埃希菌对妥布霉素、氨苄西林/舒巴坦、亚胺培南的耐药率逐年上升,耐药监测应引起更多关注。Objective To investigate the characteristic of drug resistance in clinical isolates in a hospital and to provide more information for clinical antibiotics use. Methods Data of clinical drug resistance and isolates in a hospital from 2013 to 2015 were analyzed. Results Among 8 354 samples for detection, 1 439 pathogenic bacteria were isolated including 247 Gram - positive bacteria （247/1 439,17. 16% ） and 1 192 Gram - negative bacteria （ 1 192/1 439,82.34% ）. The proportion of bacteria isolated of Escherichia coli, Klebsiella pneumonia, Acinetobacter baumannii, pseudomonas aeruginosa, were 23.8% , 14.5%, 13.3%, 12.7% and 11.6% respectively. Among 167 staphylococcus aureus, there were 89 （53.3%） Methicillin - resistant staphylococcus aureus （MRSA）. Drug sensitively test showed that cefoperazone, sulbactam and imipenem （IMP） were sensitive for Enterobacteriaceae. There were high drug resistance rates of penicillin and Erythromycin in staphylococcus aureus ; however,there was no vancomycin resistance staphylococcus aureus. The drug resistance rate of Acinetobacter baumannii （85%） was significantly higher than that of pseudomonas aeruginosa （P 〈 0. 05 ）. Piperacillin, tazobactam, cefoperazone, sulbactam and tobramycin were sensitive for pseudomonas aeruginosa. Conclusion Most of pathogenic bacteria isolated were Gram - negative. The drug resistance rates of Escherichia coli to tobramycin, ampicinllin/sulbactam, imipenem increased year by year, and more attention should be paid to the drug resistance surveillance.

关 键 词：医院 细菌 耐药 监测 

分 类 号：R181.32[医药卫生—流行病学]