2012至2016年新建大型综合民营医院细菌分布及耐药变迁  

The bacterial distribution and transition of drug resistance in newly built large-scale comprehensive private hospital from 2012 to 2016

作　　者：和培章 赵娜 范佳铮 HE Peizhang;ZHAO Na;FAN Jiazheng(Henan Hongli Hospital,Henan,Changyuan 453400,China)

机构地区：[1]河南宏力医院,河南省新乡市453400

出　　处：《河北医药》2018年第18期2854-2858,2861,共6页Hebei Medical Journal

摘　　要：目的分析2012至2016年河南宏力医院临床细菌分布及耐药性变迁特征。方法收集2012至2016年细菌室临床各类标本分离的细菌,采用美国BD公司PhoenixTM100全自动细菌分析仪分析,试验结果以美国临床和实验室标准化协会(CLSI)2014年版为判断标准,分析采用WHONET 5.6软件进行回顾性数据分析。结果 2012至2016年标本数量变化逐年呈上升趋势,总量从5 210份上升到7 607份,其中主要痰液标本从43.5%下降到34.77%,血液从22.99%上升到32.02%,尿液从14.13%降到6.74%,其他标本类型数量基本持平。2012至2016年铜绿假单胞菌、阴沟肠杆菌、屎肠球菌和酵母样不同时间分布构成差异均有统计学意义(P<>0.05),肠杆菌属细菌产ESBLs细菌耐药率远高于非产ESBLs细菌,其中2015年产ESBLs大肠埃希菌对美罗培南和亚胺培南的耐药率分别是3.05%、2%,产ESBLs肺炎克雷伯菌年对美罗培南和亚胺培南的耐药率分别是27.27%和27%;非发酵菌属对多粘菌素处于低耐药水平,最高耐药率5.71%,对碳青霉烯类抗生素耐药率均在50%以下;葡萄球菌属,未发现针对万古霉素耐药的情况,其他耐药率替考拉宁为0~9.10%、利奈唑烷为0~9.30%和奎奴普丁/达福普丁为0~9.8%;肠球菌属对万古霉素未发现耐药情况,利奈唑烷和替考拉宁处于低耐药率水平,分别为0~12.83和0~14.29%,且呈现逐年升高的趋势。结论新建民营医院,在新的环境下,标本送检存在不合理现象,耐药情况也不容乐观,所以应加大病原学检查和加强细菌耐药性监测,及时掌握细菌分布和耐药性变迁动态,对指导临床合理使用抗生素和控制多重耐药菌院内感染有重要意义。Objective To analyze the characters of clinical bacterial distribution and transition of drug resistance in Henan Hongli Hospital from 2012 to 2016. Methods The bacteria isolated from various clinical specimens in department of bacteriology of our hospital from 2012 to 2016 were collected and analyzed by Phoenix100 automatic bacterial analyzer. The experiment results were retrospectively analyzed by means of WHONET 5. 6 software according to the criteria of the 2014 edition of American Society Clinical Laboratory Standards Institute（CLSI）. Results The change of specimens number during five years from 2012 to 2016 showed an increase trend year by year,with the total amount increasing from 5210 to 7607,in which,the percentage of sputum specimens was decreased from 43. 5% to 34. 77%,and the percentage of blood specimens was increased from 22. 99% to 32. 02%,the percentage of urine specimen was decreased from 14. 13% down to 6. 74%,the number of other type specimens was basically unbiased. There were significant differences in the distribution structure of pseudomonas aeruginosa,enterobacter cloacae,enterococcus faecium,yeast-like fungi at the different time from 2012 ~ 2016（P〈0. 05）. The drug resistance rate of Escherichia coli producing ESBLs was much higher than that of non ESBLs producing bacteria,in which,the drug resistance rate to meropenem of Escherichia coli producing ESBLs in 2015 was 3. 05% and the drug resistance rate to imipenem was 2%,and the drug resistance rate to meropenem of Klebsiella pneumoniae producing ESBLs was 27. 27%,which was 27% to imipenem. Moreover the bacillosporin drug resistance of non fermentative bacteria was at lower levels,and the highest drug resistance rate was 5. 71%,and the carbapenem antibiotics resistance rate was below50%. No vancomycin resistance was found in staphylococcus,however the teicoplanin resistance rate was 0 ~ 9. 10%,the linezolid resistance rate was 0 ~ 9. 30%,the quinupristin/dalfopristin resistance rate was 0 ~ 9. 8%. No vancomycin resistance was obs

关 键 词：细菌分布 耐药监测 标本分布 

分 类 号：R915.13[医药卫生—微生物与生化药学]