我院近四年病原菌的分布及药敏监测的对比分析  

Comparative analysis on distribution and drug sensitivity of pathogenic bacteria in our hospital for four years

作　　者：张晨[1] 倪穗琴[1] ZHANG Chen;NI Sui-qin(Department of Clinical Pharmacy,Guangzhou First People′s Hospital,Guangdong Province,Guangzhou510180,China)

机构地区：[1]广州市第一人民医院临床药学科,广东广州510180

出　　处：《中国当代医药》2020年第15期169-172,共4页China Modern Medicine

基　　金：广东省广州市卫生和计划生育科技项目(20181A 010008);广东省医院药学研究基金(正大天晴基金)项目(2018A06)。

摘　　要：目的为了解我院临床分离病原菌的分布及耐药菌变迁,整理近四年抗菌药物耐药监测情况数据,为临床合理选用抗菌药物提供依据。方法收集我院2016~2019年度每季度耐药监测数据,包括主要病原菌的菌种分布情况、主要革兰阴性细菌药敏情况、多重耐药菌检出情况等,对肠杆菌科细菌及其超广谱β-内酰胺酶(ESBL)检出情况、主要革兰阴性细菌药敏情况的年度数据进行整理及统计学分析,找出细菌耐药率的变迁及差异。结果近四年总计收集24430株菌株,主要的革兰阳性菌占26.52%,前三位为凝固酶阴性葡萄球菌、肠球菌、金黄色葡萄球菌;主要的革兰阴性菌占42.40%,前三位为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌。肺炎克雷伯菌产ESBL的检出率明显增加,碳青霉烯类亚胺培南西司他丁在大肠埃希氏菌的敏感率仍较高,近年可达到97.75%。但在大肠埃希氏菌产ESBL菌株、鲍曼不动杆菌中,亚胺培南西司他丁的敏感率明显降低;在铜绿假单胞菌中,亚胺培南西司他丁的敏感率明显上升。结论医院耐药菌检测率仍有升高趋势,尤其鲍曼不动杆菌的耐药不容忽视,需加强细菌耐药的监测,提高手卫生管理等耐药菌管理措施,建立多学科专业协作管理,促进抗菌药物合理应用。Objective To understand the distribution of pathogenic bacteria and the change of drug-resistant bacteria in our hospital,and sort out the monitoring data of antimicrobial resistance in the past four years,so as to provide the basis for clinical rational selection of antimicrobial drugs.Methods The monitoring data of drug resistance every quarter from 2016 to 2019 in our hospital were collected,including the distribution of main pathogenic bacteria,the drug sensitivity of main Gram-negative bacteria,the detection of multiple drug-resistant bacteria,etc.The annual data of the detection were sorted out and statistically analyzed to find out the changes of bacterial drug resistance rate,included main Enterobacteriaceae bacteria,Extended-Spectrumβ-Lactamases(ESBL),and the drug sensitivity of main Gram-negative bacteria.Results A total of 24430 strains were collected in the past four years,the main Gram-positive bacteria accounted for 26.52%,the first three were Coagulase negative staphylococcus,Enterococcus and Staphylococcus aureus.The main Gram-negative bacteria accounted for 42.40%,the first three were Escherichia coli,Pseudomonas aeruginosa and Klebsiella pneumonia.The detection rate of ESBL produced by Klebsiella pneumoniae increased significantly.The sensitivity of Imipenem-Cilastatin increased in Pseudomonas aeruginosa significantly,with 97.75%in recent years.However,in Enterobacteriaceae bacteria producing ESBL and Acinetobacter baumannii,the sensitivity of Imipenem-Cilastatin decreased significantly.In Pseudomonas aeruginosa,the sensitivity of Imipenem-Cilastatin increased significantly.Conclusion The detection rate of drug-resistant bacteria in hospital is still increasing,especially the drug resistance of Acinetobacter baumannii can′t be ignored.It is necessary to strengthen the monitoring of bacterial drug resistance,improve the management measures of drug-resistant bacteria such as hand hygiene management,establish multi-disciplinary professional cooperative management,and promote the rational applica

关 键 词：耐药监测 碳青霉烯类 超广谱Β-内酰胺酶 药敏 

分 类 号：R117[医药卫生—公共卫生与预防医学]