2015-2017年上海市松江区非发酵革兰阴性杆菌的耐药监测研究  

Study on resistance monitoring of non-fermented gram-negative bacilli in Songjiang District, Shanghai, 2015-2017 years

作　　者：金磊 王艺翔 JIN Lei;WANG Yi-xiang(Songjiang District blood station in Shanghai, Shanghai 201600)

机构地区：[1]上海市松江区血站,上海201600 [2]上海交通大学附属第一人民医院松江分院检验科,上海201600

出　　处：《医学检验与临床》2019年第3期19-22,共4页Medical Laboratory Science and Clinics

摘　　要：目的:掌握上海市松江区2015-2017年非发酵革兰阴性杆菌的耐药情况,为临床合理用药提供数据支持。方法:回顾性分析2015-2017年上海市松江区19家医院送检的各类标本,采用梅里埃VITEK2-Compact进行细菌鉴定与药敏试验,按照CLSI 2016版标准判读结果。结果:三年共分离出1414株非发酵菌,呼吸道分泌物的检出率(69.0%)最多,其次是尿液(15.9%)。其中铜绿假单胞菌664株,占47.0%,鲍曼不动杆菌496株,占35.1%,嗜麦芽窄食单胞菌85株,占6%。三年间,鲍曼不动杆菌对氨节西林/舒巴坦、头砲曲松、庆大霉素、托布霉素、亚胺培南的耐药率呈下降趋势,铜绿假单胞菌对九种抗生素耐药率均小于20%,对复方新诺明、咲喃妥因的耐药率呈上升趋势,嗜麦芽窄食单胞菌的三年耐药率无明显变化趋势.结论:非发酵菌的耐药率较高,及时监测细菌耐药情况可以指导临床规范合理地使用抗菌药物.Objective: To investigate the drug resistance of non-fermented gram-negative bacilli in Songjiang District, Shanghai, for 2015-2017 years. Methods: A retrospective analysis of Songjiang District 2015-2017 in Shanghai city in 19 hospitals were perfbmied from all kinds of specimens by VITEK2-Compact drug sensitivity test, interpretation of the results according to the CLSI 2016 version of the standard. Results: 1414 non -fennentative bacteria strains were isolated, and the detection rate of respiratory secretions (69%) was the highest, followed by urine (15.9%). Among them, 664 Pseudomonas aeruginosa strains were isolated accounted for 47%, 496 Acinetobacter baumannii strains were isolated (35.1%), 85 Stenotrophomonas maltophilia strains were isolatedaccounting for 6%. During the three years, Acinetobacter baumannii resistance to ampicillin/sulbactam. ceftriaxone N gentamicin. tobramycin x imipenem decreased. The resistance rates of Pseudomonas aeruginosa to nine kinds of antibiotics were all <20%, and the resistance rate to compound sulfamethoxazole and furuduron showed an upward trend. The three year resistance rate of Stenotrophomonas maltophilia had no obvious change. Concllision: bacterial resistance surveillance is very important for the clinical treatment of infection and the rational use of antibiotics.

关 键 词：非发酵革兰阴性杆菌 细菌耐药性监测 抗菌药物 

分 类 号：R181.34[医药卫生—流行病学]