2013~2017年某三甲综合医院前五位多重耐药菌耐药趋势分析  

Analysis of the resistance trend of five multi-drug-resistant bacter ia in a three-tier comprehens ive hospital in 2013~2017

作　　者：冷小艳[1] 王修石 符霞 刘仕莲[1] LENG Xiao-yan;WANG Xiu-shi;FU Xia;LIU Shi-Lian(The Central Hospital of Dazhou,Sichuan 635000,China)

机构地区：[1]四川省达州市中心医院,635000

出　　处：《首都食品与医药》2020年第22期93-97,共5页Capital Food Medicine

摘　　要：目的收集并分析我院检出前五位多重耐药菌分布特点及耐药性变迁.方法采用纸片扩散法或自动化仪器法按统一方案进行药物敏感性试验.按CLSI 2017年版标准判断结果.结果2013~2017年,每年我院临床分离多重耐药菌株总数为2901~3863株,其中前五位多重耐药菌株总检出率占历年检出总菌株数的65.98%~74.05%.前五位多重耐药菌主要由痰标本中检出,又以重症医学科分布最多占历年科室分布的22.7%~29.1%.上述时间内多重耐药大肠埃希菌对亚胺培南、美罗培南及厄他培南的耐药率变化不大.多重耐药肺炎克雷伯菌对亚胺培南及美罗培南的耐药率有所上升.多重耐药铜绿假单胞菌对阿米卡星、庆大霉素、环丙沙星、亚胺培南及美罗培南的耐药率都有所下降.多重耐药鲍曼不动杆菌对亚胺培南的耐药率由83.9%上升至97.1%,对头孢哌酮/舒巴坦的耐药率也由11.3%逐步上升至36.4%.耐甲氧西林金黄色葡萄球菌对受试的四环素、克林霉素及红霉素的耐药率有所上升外对其他受试的抗菌药物的耐药率均有所下降.结论我院多重耐药鲍曼不动杆菌对亚胺培南的耐药率非常高,对头孢哌酮/舒巴坦的耐药率也有所上升,而多重耐药肺炎克雷伯菌耐药株对碳青霉烯类的耐药率也有所上升.上述结果显示多重耐药菌株的耐药性监测对于临床耐药菌感染的有效治疗具有指导作用.Objective To collect and analyze the distribution and drug resistance tend among the top five rnuhidrug-resistant bacteria in our hospital.Met hods Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automatic instrument system.The results were interpreted according to CLSI breakpoints released in 2017.Results From 2013 to 2017,the total number of multi-drug resistant strains isolated clinically in our hospital was 2,901 to 3,863,of which the total detection rate of the top five multi-drug resistant strains accounted for 65.98%to 74.05%.The top five multi-drug resistant bacteria were mainly detected in sputum specimens,and the distribution of intensive medicine departments accounted for 22.7%to 29.1%of the total distribution of departments in the calendar year.The resistance rates of multidrug-resistant E.coli to imipenem,meropenem and ertapenem kept relatively stable during few years.The resistance rate of multidrug-resistant K lebsiella pneumoniae to imipenem and meropenem increased.The resistance rate of multidrug resistant pseudomonas aeruginosa presented a downward trend to amikacin,gentamicin,ciprofloxacin,Imipenem and meropenem.The resistance rate of multidrug-resistant Acinetobacter baumannii to imipenem inereased from 83.9%to 97.1%,and the resistance rate to cefoperazonelsulbactam also increased from 11.3%to 36.4%.The resistance rates of methillin-resistant Staphylococcus aureus to tetracyeline,clindamyein,and erythromyein tested increased,while those of other antimicrobial agents tested decreased.Conclusion The resistance rate of multidrug resistant acinetobacter baumannii to imipenem was very high in our hospital.and the resistance rate to cefoperazone/sulbactam was also inereased;besides the rate of multidrug resistant Klebsiella pneurmoniae to carbapenems has also increased.The results above show that the resistance analysis of monitoring of multidrug resistant bacteria has a guiding role in the effective treatment of clinical drug-resistan

关 键 词：多重耐药菌 抗菌药物 耐药率 

分 类 号：R445[医药卫生—影像医学与核医学]