2019年上海交通大学医学院附属新华医院细菌耐药性监测  

Surveillance of antibiotic resistance of the bacterial strains isolated from Xinhua hospital,Shanghai Jiao Tong University School of Medicine in 2019

作　　者：余佳佳[1] 李虎 陶晓勤[1] 王佳玮 孙静远 陆文思 陈峰[1] Yu Jia-jia;Li Hu;Tao Xiao-qin;Wang Jia-wei;Sun Jing-yuan;Lu Wen-si;Chen Feng(Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092)

机构地区：[1]上海交通大学医学院附属新华医院,上海200092

出　　处：《中国抗生素杂志》2021年第5期442-449,共8页Chinese Journal of Antibiotics

摘　　要：目的分析上海交通大学医学院附属新华医院2019年度细菌耐药性监测结果。方法新华医院微生物实验室依据CLSI 2018年版本以及上海耐药监测网要求对临床分离的菌株进行药敏试验。并利用Whonet 5.6软件进行药敏结果统计。结果本院2019年度共检出6787株非重复菌株,其中革兰阳性菌2124株(31.3%),革兰阴性菌4663株(68.7%);检出菌株的标本类型前三位是呼吸道标本(42.8%)、尿液标本(26.5%)和血液标本(8.7%);呼吸道标本儿童患者中苛养菌的检出率明显高于成人患者。葡萄球菌属中未发现万古霉素耐药株,MRSA和MRCNS的检出率分别为46.9%和83.7%;肠球菌属中发现1株屎肠球菌对万古霉素耐药;非脑膜炎肺炎链球菌中青霉素敏感、中介和耐药株的检出率分别为93.8%、6.2%和0;大肠埃希菌、肺炎克雷伯菌和奇异变形菌ESBL的检出率分别为54.4%、22.7%和53.9%,肠杆菌科细菌CRE的检出率为15.6%,主要以肺炎克雷伯菌为主,占71.2%。非发酵菌中鲍曼不动杆菌的耐药率较高,铜绿假单胞菌、嗜麦芽寡养单胞菌和洋葱伯克霍尔德较为敏感。XDR菌株在鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌中的检出率分别为1.5%、1.7%、0.8%和0.1%。流感嗜血菌和黏膜炎莫拉菌β内酰胺酶的检出率较高,分别高达60%和95%。结论本院2019年度临床主要分离菌的耐药率较高,多重耐药菌的检出率也较高,实时细菌耐药性监测可为临床医生经验性抗感染治疗和医院感染控制提供及时有效的依据。Objective To analyze the surveillance of antibiotic resistance of the bacterial strains isolated from Xinhua hospital,Shanghai Jiao Tong University School of Medicine in 2019.Methods Xinhua hospital microbiology laboratory performed drug sensitivity test for clinical bacterial strains according to the CLSI 2018 and Shanghai antibiotic resistance monitoring network.The statistical analysis of antibiotic susceptibility was proceeded by Whonet 5.6 software.Results A total of 6,787 non-duplicate strains were isolated in our hospital in 2019,including 2,124 Gram-positive bacteria(31.3%)and 4,663 Gram-negative bacteria(68.7%).The former three specimens which have isolated bacteria were respiratory tract(42.8%),urine(26.5%),and blood(8.7%).The detection rate of fastidious bacteria in children with respiratory specimens was significantly higher than that in adults.No vancomycin resistant strains were found in Staphylococcus,and the detection rates of MRSA and MRCNS were 46.9%and 83.7%,respectively.One isolate of Enterococcus faecium was resistant to vancomycin.The detection rates of penicillin sensitive,intermediate,and resistant strains in Streptococcus pneumoniae were 93.8%,6.2%,and 0,respectively.The ESBL detection rates of Escherichia coli,Klebsiella pneumoniae,and Proteus mirabilis were 54.4%,22.7%,and 53.9%,respectively.The CRE detection rates of Enterobacteriaceae bacteria were 15.6%,and the main CRE were Klebsiella pneumoniae strains,accounting for 71.2%.The drug resistance rate of Acinetobacter baumannii in non-fermented bacteria was higher than those of Pseudomonas aeruginosa,Stenotrophomonas maltophilia,and Burkholderia cepacia.The detection rates of XDR strains in Acinetobacter baumannii,Klebsiella pneumoniae,Pseudomonas aeruginosa and Escherichia coli were 1.5%,1.7%,0.8%,and 0.1%,respectively.Theβ-lactamase detection rates of Haemophilus influenzae and Moraxella catarrhalis were higher,up to 60%and 95%,respectively.Conclusions The antibiotic resistance of the main isolates in our hospital in 2019 was severe

关 键 词：耐药性监测 多重耐药菌 广泛耐药菌 耐碳青霉烯类肠杆菌科细菌 

分 类 号：R978.1[医药卫生—药品]