2013年-2017年海岛地区5种常见临床分离菌的检出率及耐药性变迁  

Detection rate and drug resistance changes of five common clinical isolates in the island area from 2013 to 2017

作　　者：叶智颖 吕火烊[2] 郑海斌 孙霞 林芬 郑斌娜 YE Zhi-ying;LV Huo-yang;ZHENG Hai-bin;SUN Xia;LIN Fen;ZHENG Bin-na(Clinical Laboratory,Putuo District People's Hospital,Zhoushan,Zhejiang 316100,China)

机构地区：[1]舟山市普陀区人民医院检验科,浙江舟山316100 [2]浙江省人民医院检验医学中心,浙江杭州310014 [3]舟山市普陀区人民医院院感科,浙江舟山316100 [4]舟山市普陀区人民医院药剂科,浙江舟山316100

出　　处：《中国卫生检验杂志》2019年第9期1068-1072,1076,共6页Chinese Journal of Health Laboratory Technology

摘　　要：目的分析2013年-2017年本地区临床标本中5种常见分离菌的检出率及耐药性变迁,为临床合理用药提供参考依据。方法采用Phoenix微生物全自动鉴定和药敏系统,按CLSI 2017年版标准判读药敏结果,采用WHONET5.6软件进行数据分析。结果 5年间大肠埃希菌和肺炎克雷伯菌是医院获得性感染的主要分离菌,前2年大肠埃希菌检出率稍高于肺炎克雷伯菌,后3年肺炎克雷伯菌检出率反超大肠埃希菌;鲍曼不动杆菌和铜绿假单胞菌分离率逐年增加;金黄色葡萄球菌检出率及耐甲氧西林金黄色葡萄球菌(MRSA)检出率无趋势性变化;肺炎克雷伯菌和铜绿假单胞菌对碳青霉烯类药物的耐药率持续上升。结论本地区临床分离菌耐药率高,耐药监测对临床医生合理选用抗菌药物有重要作用。Objective To analyze the detection rate and drug resistance changes of five common isolates in clinical specimens from 2013 to 2017, so as to provide reference for rational clinical use. Methods Phoenix microorganism automatic identification and drug sensitivity system were adopted, the drug sensitivity results were interpreted according to CLSI 2017 standards, and WHONET 5.6 software was adopted for data analysis. Results In 5 years, Escherichia coli and Klebsiella pneumoniae were the main isolates of hospital acquired infections. The detection rate of Escherichia coli in the first two years was slightly higher than that of Klebsiella pneumoniae, and the detection rate of Klebsiella pneumoniae in the next three years was higher than that of Escherichia coli. The separation rates of Acinetobacter baumannii and Pseudomonas aeruginosa increased year by year. The detection rates of Staphylococcus aureus and methoxicillin-resistant Staphylococcus aureus(MRSA) showed no trend to change. The resistance rates of Crabella pneumoniae and Pseudomonas aeruginosa to carbapenes continued to increase. Conclu-sion The drug tolerance rate of isolated bacteria is high and drug resistance monitoring is reasonable for clinicians.

关 键 词：抗菌药物耐药性 碳青霉烯类 大肠埃希菌 肺炎克雷伯菌 鲍曼不动杆菌 铜绿假单胞菌 金黄色葡萄球菌 

分 类 号：R446.6[医药卫生—诊断学]