医院临床分离菌耐药性监测分析  

Surveillance of Drug Resistance of clinical isolates in hospital

作　　者：齐艳[1] 杨玮[1] 钱香[1] 闫涛[1] 胡笛[1] 王紫琳 Qi Yan

机构地区：[1]杭州市中医院,310007

出　　处：《浙江临床医学》2020年第6期781-783,共3页Zhejiang Clinical Medical Journal

基　　金：国家自然科学基金项目(81301490)。

摘　　要：目的了解医院临床分离菌的构成和对常用抗菌药物的敏感性和耐药性。方法对医院临床分离菌采用K-B法及自动化仪器法按统一方案进行抗菌药物敏感性试验。结果临床分离菌共6424株,其中革兰阳性菌2002株,占31.2%,革兰阴性菌4300株,占66.9%。细菌主要来源于呼吸道(46.6%)和泌尿道标本(35.6%),分离率最高的为大肠埃希菌,占16.08%(1033/6424),其次为肺炎克雷伯菌和金黄色葡萄球菌,分别占13.53%(869/6424)和13.37%(859/6424)。金黄色葡萄球菌和凝固酶阴性葡萄球菌中甲氧西林耐药株的平均检出率分别为49.1%和68.4%,未发现万古霉素和替考拉宁耐药菌株。肠球菌属中粪肠球菌对大多抗菌药物的耐药率均显著低于屎肠球菌,两者中均有少数万古霉素耐药株,粪肠和屎肠分别为0.9%和5.2%。肠杆菌科细菌对碳青霉烯类抗生素仍较为敏感,但是,肺炎克雷伯菌对亚胺培南和美罗培南的耐药率较高分别为21.7%和19%。不动杆菌属对亚胺培南和美罗培南的耐药率分别为34.1%和23.6%。结论临床分离菌对常用抗菌药物的耐药率普遍较高,应进一步加强院感防控措施和抗菌药物临床应用管理措施,持续做好细菌耐药性监测工作,指导临床合理使用抗生素。Objective To report the distribution and antibiotic resistance of bacterial strains isolated in the Hangzhou Hospital of Traditional Chinese Medicine during 2018 for improving clinical treatment of bacterial infections.Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.The results were interpreted according to the clinical and laboratory standards institute(CLSI)2018 breakpoints,and analyzed by using WHONET 5.6.Results A total of 6424 clinical isolates were collected during 2018,of which gram positive organisms accounted for 31.2%(2002/6424);and gram negative organisms 66.9%(4300/6424).The strains were mainly isolated from respiratory tract(46.6%)and urine(35.6%).The most frequently isolated microorganisms were E.coli(16.08%,1033/6424),followed by K.pneumoneae(13.53%,869/6424)and S.aureus(13.37%,859/6424).No staphylococcal strains were found resistant to vancomycin and teicoplanin.The resistance rates of E.faecalis strains to most drugs tested were much lower than those of E.faecium.A few strains of both species were resistant to vancomycin(0.9%and 5.2%).Most Enterobacteriaceae isolates were still sensitive to carbapenems.Except for K.pneumonea,the resistante rate were 21.7% and 19% to carbapenems imipenem and meropenem,respectively.About 34.1% and 23.6% of Acinetobacter spp.(A.abumannii accounts for 97%)strains were resistant to imipenem and meropenem,respectively.Conclusion Antimicrobia resistance is increasing in the clinical isolates in this hospital.We should continue to strengthen hospital infection control and management of clinical use of antimicrobial agents.

关 键 词：细菌耐药性监测 药物敏感性试验 肠杆菌科细菌 

分 类 号：R44[医药卫生—诊断学]