2014年-2016年基层综合性医院临床分离菌株的分布及耐药趋势分析  

Distribution and bacterial-resistance trend of clinical isolates in grassroots general hospitals during 2014-2016

作　　者：张金秀 叶秀珠 吴连根 ZHANG Jin-xiu;YE Xiu-zhu;WU Lian-gen(Department of Infection Control,the Second People＇s Hospital of Quzhou,Quzhou,Zhejiang 324022,China)

机构地区：[1]衢州市第二人民医院院感科,浙江衢州324022 [2]衢州市第二人民医院检验科,浙江衢州324022

出　　处：《中国卫生检验杂志》2018年第20期2534-2537,2540,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨基层医院临床分离菌株的分布及耐药状况,为合理用药提供依据。方法对2014年-2016年送检的31 198份标本进行培养、鉴定及药敏试验。结果共分离出细菌4 692株,其中革兰阴性菌3 544株,占75. 5%,主要为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌;革兰阳性菌1 148株,占24. 5%,主要为金黄色葡萄球菌、凝固酶阴性葡萄球菌、肠球菌属。药敏显示,肠杆菌对碳青霉烯类、阿米卡星、哌拉西林/他唑巴坦、阿莫西林/棒酸较敏感,对广谱青霉素、第二、三代头孢菌素耐药率较高,但有逐年降低趋势;非发酵菌对碳青霉烯类的耐药率有逐年增高趋势;革兰阳性球菌对万古霉素高度敏感,对青霉素类、喹诺酮类、大环内酯类等耐药率较高。结论基层医院,在参考全国性细菌耐药数据的同时,应着眼于本地区、本医院临床分离菌株的分布及耐药性监测数据,合理选择抗菌药物,延缓耐药菌株的产生。Objective To discuss distribution and bacterial resistance of clinical isolates in grassroots general hospitals, in order to provide basis for the rational use of antibiotics. Methods To perform incubation, identification and antimicrobial susceptibility test on the 31 198 clinical samples. Results A total of 4 692 strains were isolated, including 3 544 strains of Gram- negative baci!li, accounting for 75. 5%, mainly including Escherichia cell, Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii; 1 148 strains of Gram - positive coccus were detected, accounting for 24.5%, mainly including Staphylococcus aureus , Coagutase negative staphylococci and Enteroeoccus ; Susceptibility tests showed Enterobacteriaceae had a low resistance rate to earbapenems, amikacin, piperacillin/tazobactam, amoxicillin/elavulanic acid, while it had a high resistance rate to broad - spectrum penicillins, second and third generation cephalosporin, but with a downward trend; the resistance rate of nortfermentaters to earbapenems increased annually ; Gram - positive cocci were highly sensitive to vancomycin, and the resistance rate was higher to penieillins, quinolones and maerolides. Conclusion Grassroots general hospital, while jn reference to national bacterial resistance data, shall focus on distribution and monitoring data of bacterial resistance of clinical isolates locally and within the hospital, select the antibiotics rationally and delay the emergence of resistance strains.

关 键 词：基层医院 分离菌株 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]