2015-2017年上海交通大学医学院附属新华医院崇明分院临床常见细菌耐药性监测  

Surveillance of antibiotic resistance in the clinical isolates in Xinhua Hospital Chongming Branch,Shanghai Jiaotong University School of Medicine from 2015 to 2017

作　　者：钱敏健 张莉[1] QIAN Minjian;ZHANG Li(Department of Laboratory Medicine,Xinhua Hospital Chongming Branch,Shanghai Jiaotong University School of Medicine,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院检验科,上海202150

出　　处：《中国感染与化疗杂志》2018年第6期621-626,共6页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解上海交通大学医学院附属新华医院崇明分院常见临床分离菌耐药性,为抗菌药物合理使用和临床抗感染治疗提供参考。方法采用WHONET 5.6软件统计分析2015-2017年医院常见临床分离细菌的构成和耐药性变迁。结果收集2015-2017年患者分离菌共5278株;前3位分离菌分别为大肠埃希菌﹑肺炎克雷伯菌﹑铜绿假单胞菌,所占比例分别为24.8%、16.1%、8.4%。2015-2017年主要耐药细菌的检出率呈增高趋势。如碳青霉烯类耐药肠杆菌科细菌的逐年检出率分别为0.8%、3.5%、7.0%,甲氧西林耐药金黄色葡萄球菌的检出率分别是32.4%、41.9%、51.3%;不动杆菌属对抗菌药物的耐药率逐年上升,尤其对亚胺培南和美罗培南耐药的鲍曼不动杆菌检出率从20.3%上升到64.6%。但未发现利奈唑胺、万古霉素耐药革兰阳性菌。结论二级综合性医院中临床常见细菌对大部分抗菌药物耐药率逐年上升,特别是碳青霉烯类耐药肠杆菌科细菌对临床抗感染治疗构成严重威胁。二级综合性医院也应重视和加强细菌耐药性监测。Objective To investigate antimicrobial susceptibility profile of clinical isolates in Xinhua Hospital Chongming Branch affiliated to Shanghai Jiaotong University School of Medicine for rational use of antibiotics.Methods WHONET 5.6 software was used to analyze the distribution and susceptibility testing data of clinical isolates.Results A total of 5 278 bacterial isolates were collected from 2015 to 2017.The top three bacterial species were Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa,accounting for 24.8%,16.1%and 8.4%,respectively.The prevalence of major antibiotic-resistant bacteria was increasing.The prevealence of carbapenem-resistant Enterobacteriaceae(CRE)was 0.8%,3.5%and 7.0%in the 3 years.The prevalence of MRSA was 32.4%,41.9%,and 51.3%,respectively.The prevalence of the Acinetobacter strains resistant to antibiotics,especially to imipenem and meropenem,increased from 20.3%to 64.6%.No vancomycin-or linezolid-resistant isolates were found in gram-positive bacteria.Conclusions The clinical bacterial isolates show increasing resistance to most antibiotics during the 3-year period in this secondary care general hospital.Especially,carbapenem-resistant Enterobacteriaceae poses a serious threat.Attention should also be paid to surveillance of antimicrobial resistance in secondary care general hospital.

关 键 词：细菌 抗菌药物 耐药性监测 碳青霉烯类耐药肠杆菌科细菌 

分 类 号：R378[医药卫生—病原生物学]