某综合性教学医院2019年细菌耐药性分析  

Analysis of antimicrobial resistance in clinical isolates in a general teaching hospital in 2019

作　　者：李芳[1] 李雯[1] 袁晶[1] 王静[1] 刘哲[1] 曾晓艳[1] LI Fang;LI Wen;YUAN Jing;WANG Jing;LIU Zhe;ZENG Xiaoyan(Department of Clinical Laboratory,the First Affiliated Hospital,Xi’an Jiaotong University,Xi’an,Shaanxi 710061,P.R.China)

机构地区：[1]西安交通大学第一附属医院检验科,西安710061

出　　处：《华西医学》2020年第8期905-911,共7页West China Medical Journal

基　　金：国家自然科学基金(81201326);陕西省重点研发计划(2017SF-170)。

摘　　要：目的了解西安交通大学第一附属医院2019年临床分离常见细菌的分布以及耐药性,以指导临床合理应用抗菌药物。方法回顾性收集2019年1月—12月住院及门诊患者送检标本的分离株,研究细菌对不同抗菌药物的敏感性,根据美国临床和实验室标准协会2019年标准判读结果,采用WHONET 5.6软件分析数据。结果2019年共检出非重复菌株6784株,其中革兰阳性菌2865株,占42.2%;革兰阴性菌3919株,占57.8%。大肠埃希菌、肺炎克雷伯菌、屎肠球菌、铜绿假单胞菌和金黄色葡萄球菌检出率居所有病原菌前5位。药物敏感性试验结果显示:耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌检出率分别为33.0%和72.0%。耐万古霉素屎肠球菌的检出率为1.0%;利奈唑胺耐药屎肠球菌和粪肠球菌检出率分别为0.3%和2.9%。肺炎链球菌的成人非脑膜炎分离株均为青霉素敏感株。大肠埃希菌、克雷伯菌属和奇异变形杆菌中产超广谱β-内酰胺酶菌株检出率分别为58.2%、33.6%和33.3%。耐碳青霉烯类肠杆菌科细菌总检出率为7.8%,其中大肠埃希菌和肺炎克雷伯菌的检出率分别为1.5%和17.2%。铜绿假单胞菌对亚胺培南和美罗培南耐药率分别为25.0%和21.6%,鲍曼不动杆菌对亚胺培南和美罗培南耐药率分别为73.8%和74.2%。结论细菌耐药形势比较严峻。应加强合理用药,并采取有效防控措施,避免交叉感染。Objective To investigate the distribution and antimicrobial resistance of the clinical strains isolated from the First Affiliated Hospital of Xi’an Jiaotong University in 2019 and provide a basis for clinical rational use of antibiotics.Methods All the clinical samples which were collected from January 1 st to December 31 st in 2019 were employed to determine antimicrobial resistance retrospectively.Results were interpreted according to Clinical and Laboratory Standards Institute 2019 breakpoints and analyzed by WHONET 5.6 software.Results A total of 6784 nonduplicate strains were isolated in 2019,including 2865(42.2%)strains of Gram-positive bacteria and 3919(57.8%)strains of Gram-negative bacteria.The top five pathogens with the highest detection rate were Escherichia coli,Klebsiella pneumoniae,Enterococcus faecium,Pseudomonas aeruginosa,and Staphylococcus aureus.Methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus accounted for 33.0%and 72.0%,respectively.The detection rate of vancomycin-resistant Enterococcus faecium was 1.0%and the detection rates of linezolid-resistant Enterococcus faecium and Enterococcus faecalis were 0.3%and 2.9%,respectively.As for the nonmeningitis Streptococcus pneumoniae,the prevalence of penicillin-susceptible Streptococcus pneumoniae was 100%in the isolates from adults.Extended-spectrumβ-lactamases-producing strains accounted for 58.2%,33.6%,and 33.3%in Escherichia coli,Klebsiella spp.,and Proteus mirabilis,respectively.The total detection rate of carbapenem-resistant Enterobacteriaceae was 7.8%,among which the detection rates of carbapenem-resistant Escherichia coli and carbapenemresistant Klebsiella pneumoniae were 1.5%and 17.2%,respectively.The percentages of Pseudomonas aeruginosa strains resistant to imipenem and meropenem were 25.0%and 21.6%,respectively,and those of Acinetobacter baumannii were73.8%and 74.2%,respectively.Conclusions Bacterial resistance is still serious in this hospital.It is necessary to strengthen ratio

关 键 词：病原菌 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]