2014—2019年贵州某医院下呼吸道感染病原菌分布及耐药性  

Distribution and Drug Resistance of Pathogenic Bacteria of Lower Respiratory Tract Infection in a Hospital in Guizhou from 2014 to 2019

作　　者：陈瑢 许永杰 罗湘蓉[1] 胡方芳[1] 李红凌[1] 蒲海[1] 卢志顺 李琴 刘家玲[1] 金婷婷[1] 邢吉燕[1] 张华[1] Chen Rong;Xu Yong-jie;Luo Xiang-rong;Hu Fang-fang;Li Hong-ling;Pu Hai;Lu Zhi-sun;Li Qing;Liu Jia-ling;Xing Ji-yan;Zhang Hua(Guizhou Provincial People's Hospital,Guiyang 550001)

机构地区：[1]贵州省人民医院,贵阳550001

出　　处：《国外医药（抗生素分册）》2021年第4期241-246,共6页World Notes on Antibiotics

摘　　要：目的分析2014—2019年贵州省人民医院下呼吸道感染患者分离细菌的分布及耐药性。方法采用美国BDphoenix100全自动细菌培养鉴定仪及配套试剂进行鉴定,药敏试验采用纸片扩散法及E-Test法,按照美国临床和实验室标准协会(CLSI)中M100-S29的标准执行,采用WHONET 5.6软件对资料进行统计。结果2014年—2019年贵州省人民医院下呼吸道标本共分离23718株细菌,其中革兰阴性菌占75.66%,革兰阳性菌占24.34%,前10位细菌依次为肺炎链球菌14.64%(3742/23718)、流感嗜血杆菌14.03%(3327/23718)、肺炎克雷伯菌12.78%(3030/23718)、鲍曼不动杆菌9.20%(2182/23718)、金黄色葡萄球菌8.66%(2054/23718)、铜绿假单胞菌7.87%(2182/23718)、大肠埃希菌7.18%(1703/23718)、卡他莫拉菌4.97%(1179/23718)、嗜麦芽窄食单胞菌3.70%(878/23718)、阴沟肠杆菌3.61%(857/23718)。药敏结果显示,MRSA检出率35.7%,未发现万古霉素、利奈唑胺耐药菌株;肺炎链球菌对左氧氟沙星敏感;流感嗜血杆菌对氨苄西林耐药率在60.0%以上;肺炎克雷伯菌对碳青霉烯类药物耐药率在11.0%以上,大肠埃希菌及阴沟肠杆菌的耐药率均低于5.0%;鲍曼不动杆菌对米诺环素以外的其他抗菌药物耐药率在50.0%以上。结论贵州省人民医院下呼吸道分离细菌以革兰阴性杆菌为主,细菌耐药率呈增长趋势,应继续加强抗菌药物合理应用的管理及医院感染防控。Objective To investigate the distribution and drug resistance of bacteria isolated from patients with lower respiratory tract infection in Guizhou Provincial People’s Hospitalfrom 2014 to 2019.Methods BD PHOENIX100 automatic bacterial culture and identification instrument and matching reagent were used for identification,Bacterial susceptibility testing was performed by KB or E-Test method.Results were performed according to the standard of M100-S29 in the analysis according to Clinical and Laboratory Standards Institute(CLSI).Whonet 5.6 software was used for data statistics.Results A total of 23,718 strains of bacteria were isolated from lower respiratory tract infectionof in Guizhou Provincial People’s Hospital from 2014-2019,Gram-negative bacteria accounted for 75.66 % and Gram-positive bacteria accounted for 24.34%.The top 10 bacteria were S.pneumonia (14.64%),H.influenzae (14.03%),K.pneumoniae (12.78%),A.baumannii (9.20%),S.aureus (8.66%),P.aeruginosa (7.87%),E.coli (7.18%),M.catarrhalis (4.97%),S.maltophilia (3.7%),E.cloacae (3.61%).Results of antimicrobial susceptibility showed that the detection ratio of methicillin–resistant Staphylococcus aureus was 35.7%,and S.aureus resistant to vancomycin or linezolid was not found.S.pneumoniae strains were sensitive to levofloxacin.The resistance rate of H.influenzae to ampicillin was more than 60.0%.The resistance rate of K.pneumonia tocarbapenems was more than 11.0%.The drug resistance rates of E.coli and E.cloacae to carbapenems were less than 5.0%.The resistance rates of A.baumannii to antibiotics except minocycline were over 50.0%.Conclusion The isolates of lower respiratory tract in Guizhou Provincial People’s Hospital were mainly Gram negative bacteria,and the drug resistance rate showed an increasing trend.Therefore,we should continue to strengthen the management of rational application of antibiotics and prevention and control of nosocomial infection.

关 键 词：下呼吸道感染 细菌耐药 耐药监测 

分 类 号：R978.1[医药卫生—药品]