2018年天津市环湖医院分离的病原菌分布特征及药敏结果分析  

The Analysis of Distribution and Drug Sensitivity of Pathogens in Tianjin Huanhu Hospital in 2018

作　　者：于海淼 张乐 杨萍[1] 胡静仪[1] YU Haimiao;ZHANG Le;YANG Ping;HU Jingyi(Department of Clinical Laboratory,Tianjin Huanhu Hospital/Tianjin Key Laboratory of Cerebral Vessels and Neural Degeneration,Tianjin 300350,China)

机构地区：[1]天津市脑血管病和神经变性重点实验室/天津市环湖医院检验科

出　　处：《继续医学教育》2019年第11期131-134,共4页Continuing Medical Education

摘　　要：目的回顾性分析天津市环湖医院2018年1—12月临床分离病原菌的分布特征及其对抗菌药物的敏感性和耐药性,为临床合理用药及控制感染提供参考依据。方法按照《全国临床检验操作规程》对临床送检标本进行病原菌分离培养和鉴定,并采用VITEK 2 Compact进行细菌药物敏感性试验。结果2018年1—12月分离的非重复病原菌中,革兰阴性杆菌2201株,占74.4%,排名前三的分别是肺炎克雷伯菌、鲍曼不动杆菌和粘质沙雷菌;革兰阳性球菌715株,占24.2%,排名前三的分别是表皮葡萄球菌、金黄色葡萄球菌和人葡萄球菌;真菌40株,占1.4%。痰液分离的肺炎克雷伯菌和尿液分离的大肠埃希菌对阿米卡星、头孢替坦、替加环素及碳青霉烯类抗菌药物的敏感率均超过90.0%,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的敏感率分别超过82.0%和98.0%。脑脊液和血液分离的凝固酶阴性葡萄球菌中,甲氧西林耐药株的检出率分别为56.5%和81.1%,均未检出替加环素和万古霉素耐药菌株,其中,血液分离的凝固酶阴性葡萄球菌中有2.7%的菌株对利奈唑胺耐药。结论近年来,细菌耐药性不断增高,及时进行细菌耐药性的监测与分析,对掌握细菌的耐药趋势尤为重要,对院内感染的控制和临床抗菌药物的合理应用也意义重大。Objective To investigate the clinical distribution and antibiotic resistance of pathogens isolated from Tianjin Huanhu Hospital from January to December 2018,and to provide evidence for clinical rational drug use and infection control.Methods The isolation of bacteria was performed according to national clinical laboratory operation procedures.The mass spectrometer and VITEK II analyzer were used for the identification and drug sensitivity experiment,respectively.Results From all the pathogens isolated from January to December 2018,2201 strains(74.4%)of gramnegative bacteria were isolated,and Klebsiella pneumonia,Acinetobacter banmannii,Serratia marcescens constituted the top three strains.In grampositive bacteria,715 strains(24.2%)were isolated,Staphylococcus epidermidis,Staphylococcus aureus and human Staphylococcus were the first there types of bacteria.40 strains(1.4%)of fungus were isolated.Klebsiella pneumonia isolated from sputum and Escherichia coli isolated from urine all had a sensitivity of more than 90.0%against amikacin,cefotetan,tegacycline,carbapenems antibiotics.Besides,the sensitivities against cefoperazone sulbactam and pitopacillin tazobactam were exceeded 82.0%and 98.0%,respectively.For coagulase negative staphylococcus isolated from cerebrospinal fluid and blood,the inspection rates of methicillin-resistant were 56.5%and 81.1%,and were all resistant against tegacycline and vancomycin.In addition,2.7%of coagulase negative staphylococcus isolated from blood was linezolid-resistant.Conclusion In recent years,the resistance rate of bacteria to antibiotics keeps increasing.The monitor and analysis of drug resistance are of great importance to the trend of drug resistance,and also important for the infection control and rational use of antibiotics in clinical practices.

关 键 词：细菌分布 耐药监测 耐药性 

分 类 号：R446[医药卫生—诊断学]