2017~2019年葫芦岛市中心医院耐碳青霉烯肠杆菌科细菌耐药性监测结果分析  

Analysis of the surveillance results of carbapenem-resistant Enterobacteriaceae drug resistance in Huludao Central Hospital from 2017 to 2019

作　　者：张曼佳 ZHANG Man-jia(Department of Clinical Laboratory,Huludao Central Hospital,Liaoning Province,Huludao125000,China)

机构地区：[1]辽宁省葫芦岛市中心医院检验科,辽宁葫芦岛125000

出　　处：《中国当代医药》2021年第12期154-156,160,共4页China Modern Medicine

摘　　要：目的分析葫芦岛市中心医院耐碳青霉烯肠杆菌科细菌耐药性监测结果。方法采用EDTA协同试验、改良Hodge试验、纸片扩散法(K-B法)联合Phoenix-100全自动细菌鉴定/药敏系统对2017年1月~2019年12月葫芦岛市中心医院耐碳青霉烯肠杆菌科细菌检出情况、分布情况以及耐药性进行检测。结果2017年~2019年共分离出肠杆菌科细菌9220株,其中耐碳青霉烯肠杆菌科细菌菌株510株,总检出率5.53%(510/9220)。2017年、2018年、2019年三年检出率分别为32.55%(166/510)、34.51%(176/510)及32.94%(168/510),差异无统计学意义(P>0.05)。510株耐碳青霉烯肠杆菌科细菌菌株中的标本最主要来源为痰382株(74.90%),其他标本来源分别为胸水标本3株(0.59%),胆汁标本5株(0.98%),分泌物标本7株(1.37%),腹水标本9株(1.76%),引流液标本11株(2.16%),尿液标本20株(3.92%),导管尖端标本22株(4.31%),血液标本51株(10.00%)。2017~2019年耐碳青霉烯肠杆菌科细菌菌株对常用抗菌药物美罗培南、亚胺培南、氨曲南、头孢吡肟、头孢噻肟、头孢他啶、头孢唑林、哌拉西林/三唑巴坦、头孢哌酮/舒巴坦耐药,对替加环素及多黏菌素敏感。结论院内耐碳青霉烯肠杆菌科细菌感染率较高,最为常见的菌株为肺炎克雷伯菌,且对多数抗菌药物耐药,对替加环素、多黏菌素、复方磺胺甲噁唑、阿米卡星、庆大霉素有一定的敏感性,临床在选择用药时,应结合实际情况选择相应的抗菌药物。Objective To analyze the monitoring resistance results of carbapenem-resistant Enterobacteriaceae in Huludao Central Hospital.Methods The carbapenem Enterobacteriaceae bacteria detection,distribution and drug resistance were tested using EDTA collaborative test,modified Hodge test,Kirby-Bauer method(KB method)combining with Phoenix-100 full-automatic bacterial identification/drug susceptibility system in Huludao Central Hospital from January 2017 to December 2019.Results From January 2017 to December 2019,a total of 9220 strains of Enterobacteriaceae bacteria were isolated,of which 510 were carbapenem Enterobacteriaceae,and the total detection rate was 5.53%(510/9220).The three-year detection rates in 2017,2018,and 2019 were 32.55%(166/510),34.51%(176/510)and 32.94%(168/510),respectively,and the difference was not statistically significant(P>0.05).Among 510 carbapenem Enterobacteriaceae,the main specimen was sputum,accounting for 74.90%(382/510).The other specimen sources were 3 strains from pleural fluid specimens(0.59%),5 from bile specimens(0.98%),7 from secretions specimens(1.37%),9 from ascites specimens(1.76%),11 strains from drainage fluid specimens(2.16%),20 strains from urine specimens(3.92%),22 strains from catheter tip specimens(4.31%),51 from blood specimens(10.00%).From 2017 to 2019,the bacterial strains of carbapenem Enterobacteriaceae resisted against the commonly used antibacterial drugs such as Meropenem,Imipenem,Aztreonam,Cefepime,Cefotaxime,Ceftazidime,Cefazolin,Piperacillin/Trizobacte,and Cefoperazone/Sulbactam.The strains were sensitive to Tigecycline and polymyxin.Conclusion The infection rate of carbapenem Enterobacteriaceae in the hospital is relatively high.The most common strain is Klebsiella pneumoniae,which is resistant to most antibacterial drugs.It is resistant to Tigecycline,Polymyxin,Cotrimoxazole,Amikacin,and Gentamicin to a certain degree.When choosing drugs in clinic,the corresponding antibacterial drugs should be selected based on the actual situation.

关 键 词：耐碳青霉烯肠杆菌科 细菌耐药性监测 来源分布 EDTA协同试验 改良HODGE试验 纸片扩散法 Phoenix-100全自动细菌鉴定/药敏系统 

分 类 号：R446.1[医药卫生—诊断学]