2017年至2019年阜阳某三级医院常见病原菌分布和细菌耐药性分析  

Distribution and Drug Resistance of Common Pathogenic Bacteria in a Tertiary Hospital in Fuyang from 2017 to 2019

作　　者：陆国平 许义侠 张敏 陈小坤 汪春新 LU Guo-ping;XU Yi-xia;ZHANG Min;CHEN Xiao-kun;WANG Chun-xin(Laboratory Department of Fuyang Hospital Affiliated to Anhui Medical University,Fuyang,Anhui,236000,China)

机构地区：[1]安徽医科大学附属阜阳医院检验科,安徽阜阳236000

出　　处：《现代生物医学进展》2020年第10期1922-1928,共7页Progress in Modern Biomedicine

基　　金：安徽省转化医学研究院科研基金项目(2017zhyx14)。

摘　　要：目的:分析本院2017年~2019年常见病原菌分布和细菌耐药性情况,以指导临床用药。方法:将送检标本中的病原菌进行鉴定,参照CLSI 2017版判读药敏结果。结果:收集2017年7月~2019年6月临床分离菌共2292株,其中革兰阴性菌1862株,占81.2%,革兰阳性菌430株,占18.8%。大肠埃希菌占比最高,占25.7%。主要分离于尿液标本(55.9%)、血液标本(12.2%)和痰液标本(10.8%)。金黄色葡葡球菌中MRSA(耐甲氧西林金黄色葡萄球菌)和凝固酶阴性葡萄球菌中耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为61.4%和74.4%。MRSA主要分布于普外科、神经外科和骨科。未检出替考拉宁、利奈唑胺或万古霉素耐药的葡萄球菌。肠球菌属中屎肠球菌对测试药物的耐药率均较高。16株肺炎链球菌,其中3株对青霉素耐药。肠杆菌科细菌中,肺炎克雷伯菌对碳青霉烯耐药率为14.5%。鲍曼不动杆菌对碳青霉烯的耐药率为76.9%。铜绿假单胞菌为19.3%。14株流感嗜血杆菌中,β内酰胺酶检出率为35.7%(5/14)。结论:2017年~2019年我院常见病原菌以革兰阴性杆菌为主,病原菌的耐药性较高,临床应加强科室管理,合理应用抗生素,防耐药菌株的流行,降低医院感染的发生风险。Objective: To analyze the distribution and drug resistance of common pathogenic bacteria in our hospital from 2017 to 2019, so as to guide clinical medication. Methods: Pathogenic bacteria in the samples were identified and drug sensitivity results were interpreted according to CLSI 2017 edition. Results: A total of 2292 clinical isolates were collected from July 2017 to June 2019, including1862 Gram-negative bacteria(81.2%) and 430 Gram-positive bacteria(18.8%). Escherichia coli accounted for 25.7% of the total. They were mainly isolated from urine samples(55.9%), blood samples(12.2%) and sputum samples(10.8%). The detection rates of MRSA(methicillin-resistant staphylococcus aureus) and MRCNS(methicillin-resistant coagulase-negative staphylococcus) in staphylococcus aureus were 61.4% and 74.4%. MRSA was mainly distributed in general surgery, neurosurgery and orthopedics. No teicoplanin, linezolid or vancomycin resistant staphylococci were detected. Enterococcus belongs to Enterococcus faecium with high drug resistance rate to the tested drugs. 16 strains of Streptococcus pneumoniae, 3 of which were resistant to penicillin. In Enterobacteriaceae, Klebsiella pneumoniae was 14.5% resistant to carbapenem. The drug resistance rate of Acinetobacter baumannii to carbapenem was 76.9%. Pseudomonas aeruginosa was 19.3%. Among 14 strains of Haemophilus influenzae, the detection rate of β-lactamase was 35.7%(5/14). Conclusion:Gram-negative bacilli are the most common pathogenic bacteria in our hospital from 2017 to 2019. The drug resistance of pathogenic bacteria is relatively high. Clinically, we should strengthen department management, rationally apply antibiotics, prevent the prevalence of drug-resistant bacteria, and reduce the risk of hospital infection.

关 键 词：药物敏感性试验 耐碳青霉烯类肠杆菌科细菌 细菌耐药监测 

分 类 号：R969.3[医药卫生—药理学] R197.323.4[医药卫生—药学]