乌苏地区近5年细菌耐药性监测分析  

Germ tolerance monitoring analysis in WuSu district during the past 5 years

作　　者：尚丽霞[1] 刘明 王雪蕊 史颖[1] 包芙莉 李丹 刘通 姚蕾 SHANG Li - xia, LIU Ming, WANG Xue - rui, SHI Ying, BAO Fu - li, LI Dan, LIU Tong, YAO Lei(The Fifteenth Hospital Laboratory of People＇s Liberation Army, Wusu ,Xinjiang 833000, Chin)

机构地区：[1]乌苏市解放军第十五医院检验科,新疆乌苏833000

出　　处：《现代预防医学》2018年第7期1338-1341,共4页Modern Preventive Medicine

摘　　要：目的通过对乌苏地区近5年细菌耐药性监测分析,为合理用药提供依据。方法回顾分析2 425株病原菌的分布及耐药情况。结果病原菌的来源以伤口分泌物、尿液和痰液为主,分布以革兰阴性(G-)杆菌为主,占51.22%,革兰阳性(G+)球菌和真菌各占45.65%和3.13%。主要的病原菌是凝固酶阴性的葡萄球菌、大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和肠球菌等。大多数病原菌除对亚胺培南、头孢哌酮/舒巴坦敏感外(耐药率<20%),对青霉素、红霉素、克林霉素、氨苄西林和一、二代头孢菌素的耐药率超过70%,对三代头孢类和氨基糖苷类的耐药率超过30%;非发酵菌属对常用抗菌药物的耐药率普遍高于肠杆菌(除氨曲南和妥布霉素外);酶抑制剂能明显降低G-杆菌的耐药率;多重耐药菌呈逐年上升趋势;未发现万古霉素耐药株。结论乌苏地区近5年细菌耐药形势严峻,临床应结合本地耐药监测结果,合理选择抗菌药物,以防止耐药的孳生扩散。Objective To monitor and analyze the germ tolerance in WuSu district during the past 5 years, and to provide the basis of using antibacterial drugs effectively and correctly. Methods The distribution and drug resistance of 2 425 strains of pathogenic bacteria were analyzed retrospectively. Results Pathogenic bacteria＇s main resource were oral secretion, sputum and urine. The distribution of pathogenic bacteria was main Gram- negative bacilli （51.22%）, Gram- positive coccus and fungus each accounted for 45.65% and 3.13%. Main bacteria were coagulase - negative Staphylococci, E. coli, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, enterococcus and so on. Drug sensitivity assay indicated that in the most pathogenic bacteria had the highest drug resistance （ resistance rate 〉 70% ） to penicillin, erythromycin, clindamycin, ampicillin, cephalosporin, two generation cephalosporin, had the resistance （ resistance rate 〉 30% ） to third -generation cephalosporin and aminoglycosides, and had the most sensitivity （resistance rate 〈 20% ） to imipenem and cefoperazone. The resistance rate of non - fermenting bacteria to antibacterial agents was generally higher than that of Enterobacteriaceae （except Aztreonam and Tobramycin）. Enzyme inhibitors could significantly reduce the resistance rate of Gram - negative bacilli. Multiple drug - resistant bacteria were in upward trend of yearly. Vancomycin resistant strain was not found. Conclusion The situation of bacterial resistance is grim in WuSu district during the Past 5 years. The clinical selection of antibiotics should be combined with the results of local drug resistance monitoring to prevent the breeding and diffusion of drug resistance.

关 键 词：病原菌 抗菌药物 耐药监测 

分 类 号：R181.23[医药卫生—流行病学]