苏州市某三甲医院2017年临床分离菌耐药性监测  

Surveillance of drug resistance of clinical isolation bacteria in some tertiary hospital in Suzhou in 2017

作　　者：赵丽娜[1] 张险峰[1] 朱琼芳[1] 陈旭[1] 任亚璐[1] 徐杰[1] ZHAO Li-na;ZHANG Xian-feng;ZHU Qiong-fang;CHEN Xu;REN Ya-lu;XU Jie(Center for Clinical Laboratory,the First Affiliated Hospital of Soochow University,Suzhou Jiangsu 215006,China)

机构地区：[1]苏州大学附属第一医院临床检测中心

出　　处：《中国消毒学杂志》2020年第1期33-36,共4页Chinese Journal of Disinfection

摘　　要：目的了解苏州大学附属第一医院2017年临床分离菌对临床常用抗菌药物的耐药性,为临床合理用药提供参考依据。方法采用纸片扩散法和自动化仪器进行细菌体外药敏试验,并用Whonet 5. 6软件进行统计分析。结果 2017年共分离9 106株非重复菌株,其中革兰阳性菌2 549株,占28. 0%,革兰阴性菌6 557株,占72. 0%。金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌中甲氧西林耐药株(MRCNS)的检出率分别为53. 8%和71. 6%。MRSA和MRCNS对绝大多数测试药物的耐药率均明显高于甲氧西林敏感株(MSSA和MSCNS)。MRSA中有94. 0%菌株对甲氧苄啶-磺胺甲唑敏感;MRCNS中有76. 4%的菌株对四环素敏感;未发现万古霉素耐药株。肠球菌属中粪肠球菌对多数测试抗菌药物(四环素除外)的耐药率均显著低于屎肠球菌,粪肠球菌检出1株利奈唑胺耐药株,屎肠球菌检出5株万古霉素耐药株。除肺炎克雷伯菌外,多数肠杆菌科细菌对碳青霉烯类抗生素仍高度敏感,耐药率低于6%。mCIM试验显示CR-KPN 99. 17%产碳青霉烯酶。结论临床分离菌耐药率呈增长性趋势,尤其是碳青霉烯类耐药肺炎克雷伯菌,应继续加强抗菌药物应用管理,做好医院感染防控工作。Objective To investigate the drug resistance of clinical isolates from the First Affiliated Hospital of Soochow University in 2017,so as to provide reference and basis for clinical rational drug use. Methods The paper diffusion method and automatic instrument were used to carry out antimicrobial susceptibility test in vitro,and analyzed statistically using Whonet 5. 6 software. Results A total of 9 106 clinical isolates were collected in 2017,of which 2 549 were Gram-positive strains that accounting for 28. 0% and 6 557 were Gram-negative strains accounting for 72. 0%. The detection rates of methicillin-resistant strains was 53. 8% in Staphylococcus aureus( MRSA) and 71. 6% in coagulase negative Staphylococcus( MRCNS). The resistance rates of MRSA and MRCNS to most of the tested drugs were significantly higher than that of methicillin sensitive strains( MSSA and MSCNS). However,94. 0% of MRSA strains were sensitive to trimethoprim sulfamethoxazole;76. 4% of MRCNS strains were sensitive to tetracycline. No vancomycin resistant strains were found. The resistance rate of E. faecalis to most of the tested antibiotics( except tetracycline) was significantly lower than that of E. faecium. One linezolid resistant strain was detected in E. faecalis,and five vancomycin resistant strains were detected in E. faecium. In addition to K. pneumoniae,most Enterobacteriaceae bacteria were still highly sensitive to carbapenems,and the resistance rate is lower than 6%. The results showed that 99. 17% of CR-KPN produced carbapenem. Conclusion The drug resistance rate of clinical isolates is still on the rise,especially carbapenem resistant Klebsiella pneumoniae. It is necessary to strengthen the management of antimicrobial application and do a good job in the prevention and control of hospital infection.

关 键 词：细菌耐药性监测 药物敏感性试验 耐甲氧西林葡萄球菌 碳青霉烯类耐药革兰阴性菌 

分 类 号：R446.5[医药卫生—诊断学]