衡阳地区某三甲医院2017-2019年耐碳青霉烯菌检出情况分析  

Retrospective Analysis of Carbapenem-Resistant Bacteria Detection from 2017-2019 in a 3A Hospital of Heng Yang

作　　者：肖春兰 彭进展 王秋平[1] 周湘萍 刘双全[1] XIAO Chunlan;PENG Jinzhan;WANG Qiuping;ZHOU Xiangping;LIU Shuangquan(The First Affiliated Hospital of University of South China,Department of Clinical Laboratory,Hengyang 421001,China;The Second Affiliated Hospital of University of South China,Pharmacy Department,Hengyang 421000,China)

机构地区：[1]南华大学附属第一医院检验医学中心,湖南衡阳421001 [2]南华大学附属第二医院药剂科,湖南衡阳421000

出　　处：《湖北民族大学学报（医学版）》2020年第3期65-68,共4页Journal of Hubei Minzu University(Medical Edition)

基　　金：国家自然科学基金(81201331)。

摘　　要：目的分析南华大学附属第一医院近3年耐碳青霉烯菌的分离情况和药物敏感性测试结果,分析近期耐碳青霉烯菌感染和耐药变迁趋势。方法回顾分析南华大学附属第一医院2017年1月-2019年12月临床耐碳青霉烯菌的分离结果、标本来源和耐药情况,采用Whonet 5.6和SPSS 22.0软件处理分析数据。结果2017-2019年临床标本共检出耐碳青霉烯菌2387株,检出率20.77%,其中非发酵革兰氏阴性杆菌1774株,肠杆菌科细菌613株,检出率居前三位的是脑膜脓毒性菌(100%)、产吲哚金黄杆菌(76.92%)、鲍曼不动杆菌(73.12%)。阳性标本来源最多为痰,占比77.50%。药物敏感性测试结果显示耐碳青霉烯菌肠杆菌科细菌对阿米卡星、妥布霉素、庆大霉素具有较高敏感性,耐碳青霉烯非发酵革兰氏阴性杆菌对阿米卡星、哌拉西林/他唑巴坦、妥布霉素和庆大霉素具有较高敏感性,而耐碳青霉烯菌对其它抗生素均表现出高度耐药性。结论近期耐碳青霉烯菌检出数量呈上升趋势,并显示出广泛的抗生素耐药性,建议加强其分布和耐药性监测,以指导临床合理使用抗生素。Objective Through investigating the isolation and drug sensitivity test results of carbapenem-resistant bacteria(CRB)in our hospital in the past three years to understand the variations of tendency of drug-resistance and infection status caused by CRB.Methods By retrospecting the specimen source of clinically separated CRB,separation results and drug resistance in our hospital from 2017 to 2019,the data were analyzed by Whonet 5.6 and SPSS 22.0 software.Results A total of 2,387 CRB strains were isolated from 2017 to 2019,with a detection rate of 20.77%.Among them,1,774 strains were non-fermented gram-negative bacilli and 613 strains were enterobacteriaceae bacteria.The highest three detection rates was found in Elizabethkingia meningosepticum(100%),Chryseobacterium indologenes(76.92%)and Acinetobacter baumannii(73.12%).The main sources of specimen of CRB was sputum,which contributing77.50%of the CRB strains.Drug sensitivity test results showed that carbapenem-resistant enterobacteria(CRE)were highly sensitive to amikacin,tobramycin and gentamicin,while carbapenem resistantnon-fermented gram-negative bacilli were highly sensitive to amikacin,Piperacillin/Tazobactam,tobramycin and gentamicin.Conclusion The number of CRB isolation has increased gradually in recent years,and shows multiple-drug resistance.Therefore,the distribution and drug resistance monitoring should be strengthened in order to guide the rational use of antibiotics.

关 键 词：耐碳青霉烯菌 回顾性分析 抗生素耐药 

分 类 号：R446.5[医药卫生—诊断学]