北京市69家医院常见病原菌分布及耐药性分析  

Analysis for the pathogenic bacteria distribution and drug resistance in 69 hospitals in Beijing

作　　者：代利利 张晓兰[1] 成华[1] 张芳[2] 冯维超 DAI Lili;ZHANG Xiaolan;CHENG Hua(Department of Pharmacy,Luhe Hospital Affiliated to Capital Medical University,Beijing 101100,China)

机构地区：[1]首都医科大学附属北京潞河医院药剂科,北京市101149 [2]首都医科大学附属北京潞河医院检验科,北京市101149

出　　处：《河北医药》2019年第18期2870-2873,共4页Hebei Medical Journal

基　　金：北京市通州区卫生发展科研专项项目(编号:TFZXPT-20180112)

摘　　要：目的了解北京市病原菌分布及耐药情况,为临床合理应用抗菌药物提供参考。方法收集2016年10月至2017年9月北京市69家医院的细菌耐药监测数据,剔除重复菌株,仅保留同一患者相同细菌第一株的原则。分析各类培养标本所分离的细菌及药敏结果。结果共收集细菌总数为123764株,其中革兰阳性菌占30.1%(37245/123764),革兰阴性菌占69.9%(86519/123764)。革兰阳性菌分离率排名前五位的是:金黄色葡萄球菌、粪肠球菌、屎肠球菌、表皮葡萄球菌和无乳链球菌。革兰阴性菌分离率排名前五位的是:大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和阴沟肠杆菌。主要标本来源包括痰液(39.9%)、尿(20.8%)、血液(9.8%)和伤口脓液(3.5%)。耐甲氧西林的金黄色葡萄球菌(MRSA)的检出率为36.3%,耐甲氧西林的凝固酶阴性葡萄球菌(MRCNS)的检出率为79.9%,未发现万古霉素、替考拉宁及利奈唑胺耐药菌株。鲍曼不动杆菌对多数药物耐药率较高,对亚胺培南和美罗培南的耐药率均超过60%。结论 北京市2017年病原菌检出情况不容乐观,应根据病原菌的分布及其耐药性合理选用抗菌药物。Objective To investigate the pathogenic bacteria distribution and drug resistance in 69 hospitals in Beijing in order to provide reference for rational application of antibiotics in clinical practice.Methods The surveillance data of bacterial drug resistance from October 2016 to September 2017 were collected for analysis,which included 69 hospitals in Beijing,which excluded the duplicate strains and kept the first strain of the same bacteria in the same patient.The bacteria isolated from various culture samples and drug susceptibility results were analyzed.Results A total of 123,764 strains of bacteria were collected in 2017,in which,Gram-positive bacteria accounted for 30.1%(37,245/123,764) and Gram-negative bacteria accounted for 69.9%(86,519/123,764).The top five Gram-positive bacteria were Staphylococcus aureus,Enterococcus faecalis, Enterococci, Staphylococcus epidermidis and Streptococcus agalactiae.The top five gram-negative bacteria were E.coli,K.pneumoniae, pseudomonocyte,Acinetobacter baumannii and Enterobacter cloacae. The main sample sources included sputum(39.9%),urine(20.8%),blood(9.8%) and wound pus(3.5%).The detection rate of methicillin-resistant Staphylococcus aureus(MRSA) was 36.3%,that of methicillin-resistant coagulase-negative staphylococci(MRCNS) was 79.9%.No resistant strains of vancomycin, teicoplanin and linezolid were found.The resistance rate of Acinetobacter baumannii to most drugs was higher, and its resistance rate to imipenem and meropenem was more than 60%.Conclusion The situation of pathogen detection in Beijing in 2017 is not optimistic.It is necessary to reasonably use antibiotics according to the distribution and drug resistance of the pathogens.

关 键 词：病原菌 分布 耐药性 分析 

分 类 号：R197[医药卫生—卫生事业管理]