某三甲综合医院2017—2018年临床分离细菌耐药性监测  

Surveillance of Drug Resistance in Clinical Isolates of a Top Three General Hospital from 2017 to 2018

作　　者：王发丽 胡昭宇 武静 李波 李雨莎 郭巧巧 赵德军 Wang Fa-li;Hu Zhao-yu;Wu Jing;Li Bo;Li Yu-sha;Guo Qiao-qiao;Zhao De-jun(The 925th Hospital of the PLA Logistics Support Force,Guiyang 550009;The first People’s Hospital of Qingzhen City,Qingzhen 551400)

机构地区：[1]中国人民解放军联勤保障部队第九二五医院,贵阳550009 [2]清镇市第一人民医院,清镇551400

出　　处：《国外医药（抗生素分册）》2020年第2期121-127,共7页World Notes on Antibiotics

摘　　要：目的对某三甲综合医院2017年—2018年临床分离细菌的耐药性进行监测,为抗菌药物合理应用提供参考依据。方法收集某三甲综合医院2017年1月1日—2018年12月31日临床分离细菌,通过法国梅里埃VITEK 2 compact分析仪进行细菌鉴定,MIC法和纸片扩散(K-B)法进行药敏试验,并使用WHONET 5.6软件对资料进行统计分析。结果共收集非重复细菌3854株,有54.9%细菌来源于呼吸道标本,有25.6%细菌分离自ICU病区,革兰阴性菌占73.9%(2849/3854),以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、嗜麦芽寡养假单胞菌和鲍曼不动杆菌为主,分别占29.2%、13.0%、11.2%、6.0%、4.4%;革兰阳性菌占26.1%(1005/3854),以金黄色葡萄球菌、表皮葡萄球菌、粪肠球菌和屎肠球菌为主,分别占10.6%、3.2%、2.0%、1.4%。葡萄球菌对青霉素G100.0%耐药,对红霉素和克林霉素耐药率>60.0%,未出现万古霉素、利奈唑胺、替加环素耐药菌株,耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为58.8%、80.1%。除氯霉素外,屎肠球菌的耐药率显著高于粪肠球菌,对红霉素、四环素、环丙沙星、左氧氟沙星和青霉素G的耐药率均>80.0%,对万古霉素耐药率为1.8%。肺炎链球菌对克林霉素和四环素的耐药率>90.0%,对青霉素G的耐药率为5.3%。β-溶血链球菌和草绿色链球菌对红霉素和克林霉素的耐药率均>80.0%,对青霉素G的耐药率分别为6.3%、2.8%。大肠埃希菌产超广谱β-内酰胺酶(ESBLs)的检出率为52.1%,对氨苄西林和头孢唑啉的耐药率>65.0%,对环丙沙星和左氧氟沙星耐药率分别为46.9%和43.4%,对亚胺培南和美罗培南的耐药率分别为2.6%、3.2%。肺炎克雷伯菌和奇异变形杆菌产ESBLs的检出率分别为31.7%、13.8%,对头孢他啶、头孢吡肟、妥布霉素、哌拉西林/三唑巴坦、头孢替坦和阿米卡星的耐药率<10.0%,对亚胺培南的耐药率分别为2.5%�Objective To monitor the drug resistance of clinically isolated bacteria in a top three general hospital from 2017 to 2018,and provide a reference basis for the rational application of antibacterial drugs.Methods Bacteria isolated from cultured specimens of in patients in a third-grade class-A hospital during 2017~2018 was identified by VITEK2 compactanalyser.susceptibility test was performed by MIC method and K-B programe,and data were analyzed statiscally using WHOET 5.6 software.Results 3854 non repetitive pathogens were isolated,among which respiratory tract specimen accounted for 54.9%and 25.6%of bacteria was from ICU wards.Gram-negative bacteria accounted for 73.9%(2849/3854).Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumonia,Pseudomonas maltophilia,and Acinetobacter baumannii are the main types,accounting for 29.2%,13.0%,11.2%,6.0%,and 4.4%,respectively;Gram-positive bacteria account for 26.1%(1005/3854)of which Staphylococcus aureus,Staphylococcus epidermidis.Enterococcus faecalis,and Enterococcus faecium are the main species,accounting for 10.6%,3.2%,2.0%,and 1.4%,respectively.The resistance rate of penicillin against Staphylococci was 100%and theresistant rate of erythromycin and clindamycin was more than 60%,and no vancomycin,linezolid,and tigecycline resistant bacteria have appeared.The detection rates of MRSA and MRCNS were 58.8%and 80.1%respectively.The resistance rate of erythromycin,tetracyclin,ciprofloxacin,levofloxacin and penicillin G against Enterococus faecium were above 80%and that of vancomycin 1.8%,which was significantly higher than the rate against Enterococcus faecalis,except chloramphenicol.The resistance rate of Streptococcus pneumoniae to clindamycin and tetracycline exceeded 90.0%,and the resistance rate to penicillin G was 5.3%.The resistance rates ofβ-hemolytic streptococcus and Streptococcus green strains to erythromycin and clindamycin were more than 80.0%,the resistance rates to penicillin G were 6.3%and 2.8%,respectively.The detection rate of ESBLs produced by Esche

关 键 词：病原菌 耐药性监测 抗菌药物 药物敏感试验 

分 类 号：R446.5[医药卫生—诊断学]