2018年某地区呼吸道革兰阴性菌分布及耐药性分析  

Analyses on distribution and drug resistance of Gram-negative bacteria in respiratory tract of a region in 2018

作　　者：韩杰[1] 马淑青[1] 于旭云 张积平 毕艳妮[1] 孙梅[1] 孙大林[1] 解洁[1] 王颖[1] Han Jie;Ma Shuqing;Yu Xuyun;Zhang Jiping;Bi Yanni;Sun Mei;Sun Dalin;Xie Jie;Wang Ying.(Central Laboratory, Weihai Municipal Hospital, Weihai 264200, Shandong, China)

机构地区：[1]威海市立医院中心实验室

出　　处：《实用检验医师杂志》2019年第2期69-71,共3页Chinese Journal of Clinical Pathologist

基　　金：国家科技重大专项(2013ZX10004217);山东省保健科技协会科学技术课题(SDBJKT20180035)~~

摘　　要：目的了解2018年威海地区8家医院呼吸道革兰阴性(G^-)病原菌的分布及其对临床常用抗菌药物的耐药性,为临床合理使用抗菌药物提供参考依据。方法 8家入网医院按照统一方法统计分析细菌耐药性,药敏试验采用自动化仪器法、纸片扩散法(K-B法)以及E试验法,参照美国临床实验室标准化协会(CLSI)2017年标准判读结果,应用Whonet 5.6软件对引起呼吸道感染的G^-分离菌的分布情况和耐药性进行统计分析。结果 2018年8家医院共分离G^-细菌2 443株,检出率前5位细菌依次为铜绿假单胞菌(27.2%)、肺炎克雷伯菌(26.8%)、鲍曼不动杆菌(13.3%)、流感嗜血杆菌(7.6%)、大肠埃希菌(4.7%)。药敏试验结果显示:流感嗜血杆菌对头孢曲松、左氧氟沙星的敏感率均>85%;肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌和铜绿假单胞菌对亚胺培南的耐药率分别为1.7%、6.8%、64.3%和9.3%;鲍曼不动杆菌对替加环素、黏菌素的敏感率均>95%;铜绿假单胞菌对庆大霉素、阿米卡星、头孢他啶、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的敏感率均>70%。结论 G^-菌是引起呼吸道感染的主要病原菌,产超广谱β-内酰胺酶(ESBLs)的肺炎克雷伯菌和大肠埃希菌的检出率均低于全国平均检出率,但耐碳青霉烯类大肠埃希菌的检出率高于全国平均检出水平。Objective To understand the distribution of gram-negative(G^-) pathogenic bacteria in respiratory tract in Weihai hospitals and their resistance to commonly used antibiotics in order to provide a reference for rational use of antibiotics in clinical practice. Methods According to a unified method, statistical analysis of bacterial drug resistance was carried out in 8 hospitals enrolled in a network. The drug sensitivity test was conducted by automated instrument method, disk diffusion method(K-B method) and E test method. The criteria in American Clinical Laboratory Standardization Institute(CLSI) 2017 edition were used as the references, the results were judged, and Whonet 5.6 software was applied to statistically analyze the distribution and drug resistance of G^-pathogenic bacteria isolated from the respiratory tract specimens. Results A total of 2 443 G^-bacterial strains were isolated from the 8 hospitals in 2018, and the top five bacterial detection rates in sequence from high to low were Pseudomonas aeruginosa(27.2%), Klebsiella pneumoniae(26.8%), Acinetobacter baumannii(13.3%), Haemophilus influenzae(7.6%) and Escherichia coli(4.7%). The susceptibility test results showed that the susceptibility rates of haemophilus influenzae to ceftriaxone and levofloxacin were more than 85%;the drug resistance rates of Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa to imipenem were 1.7%, 6.8%,64.3% and 9.3% respectively;the sensitivity rates of Acinetobacter baumannii to tigacycline and myxomycin were all more than 95%;the sensitivity rates of Pseudomonas aeruginosa to gentamicin, amikacin, ceftazidine, piperacillin/tazobatan and cefoperazone/sulbactan were all more than 70%. Conclusions G^-bacteria are the main pathogenic bacteria of respiratory tract infection. The detection rates of Klebsiella pneumoniae and Escherichia coli producing extended spectrum beta-lactamases(ESBLs) are lower than those of the national average, but the detection rate of carbapenem-resistant Esche

关 键 词：呼吸道感染 革兰阴性菌 耐药性监测 

分 类 号：R446.5[医药卫生—诊断学]