2017年北京协和医院细菌耐药性监测  

Surveillance of antimicrobial resistance in Peking Union Medical College Hospital in 2017

作　　者：刘文静[1] 徐英春[1] 杨启文[1] 王瑶[1] 王贺[1] 孙宏莉[1] 赵颖[1] 刘亚丽[1] 郭丽娜[1] 窦红涛[1] 朱任媛[1] 张丽[1] 肖盟[1] 张小江[1] LIU Wenjing;XU Yingchun;YANG Qiwen;WANG Yao;WANG He;SUN Hongli;ZHAO Ying;LIU Yali;GUO Lina;DOU Hongtao;ZHU Renyuan;ZHANG Li;XIAO Meng;ZHANG Xiaojiang(Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院检验科,北京100730

出　　处：《中国感染与化疗杂志》2018年第6期614-620,共7页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解2017年北京协和医院临床分离细菌对抗菌药物的耐药性。方法收集2017年1月1日-12月31日该院临床分离的9515株非重复细菌,采用纸片扩散法、部分抗菌药物补充E试验法进行药敏试验。结果 9515株非重复细菌中,革兰阴性菌占68.2%,革兰阳性菌占31.8%。耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)的检出率分别占各自菌种的25.6%和73.3%。产超广谱β内酰胺酶的大肠埃希菌、克雷伯菌属(肺炎克雷伯菌和产酸克雷伯菌)和奇异变形杆菌的检出率分别为47.6%(877/1842)、27.6%(335/1213)和33.0%(59/179)。肠杆菌科细菌对碳青霉烯类仍高度敏感,总耐药率≤3.8%,但是肺炎克雷伯菌对亚胺培南和美罗培南的耐药率分别为8.5%和8.2%;鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别为72.7%和70.4%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为14.8%和10.0%。鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌广泛耐药菌株的检出率分别是31.7%(239/753)、1.0%(10/1035)和3.0%(33/1 117)。结论该院临床分离的常见细菌对不同抗菌药物呈现不同耐药率,应加强实验室与临床的沟通,合理使用抗菌药物,避免耐药菌株的广泛传播。Objective To investigate the antimicrobial resistance of clinical bacterial isolates in Peking Union Medical College Hospital(PUMCH)in 2017.Methods A total of 9 515 non-duplicate clinical isolates were collected from January 1 to December 31,2017.Disc diffusion test(Kirby-Bauer method)and E-test method were employed to determine antimicrobial susceptibility.Results Gram-negative bacilli and gram-positive cocci accounted for 68.2%and 31.8%,respectively among the 9 515 clinical isolates.Methicillin-resistant strains in S.aureus(MRSA)and coagulase-negative Staphylococcus(MRCNS)accounted for 25.6%and 73.3%,respectively.Extended-spectrumβ-lactamases(ESBLs)-producing strains accounted for 47.6%(877/1 842),27.6%(335/1 213)and 33.0%(59/179)in E.coli,Klebsiella spp(K.pneumoniae and K.oxytoca)and P.mirabilis,respectively.Enterbacteriaceae strains were still highly susceptible to carbapenems,with an overall resistance rate of≤3.8%.The resistance rates of K.pneumoniae to imipenem and meropenem were 8.5%and 8.2%,respectively.About 72.7%and 70.4%of A.baumannii isolates were resistant to imipenem and meropenem.The resistance rate of P.aeruginosa to imipenem and meropenem was 14.8%and 10.0%,respectively.The prevalence of extensively drug-resistant strains in A.baumannii,P.aeruginosa and K.pneumoniae was 31.7%(239/753),1.0%(10/1 035),and 3.0%(33/1 117),respectively.Conclusions The common bacterial isolates show various level of resistance to antimicrobial agents.Laboratory staff should improve communication with clinicians to prevent the spread of resistant strains.

关 键 词：细菌耐药性监测 抗菌药物 广泛耐药菌 药敏试验 

分 类 号：R378[医药卫生—病原生物学]