2020年山东省枣庄市立医院常见病原菌分布和耐药性监测分析  

Distribution and antimicrobial resistance analysis of clinical bacteria in Zaozhuang Municipal Hospital,Shandong Province in 2020

作　　者：胡乐兰[1] 古新芳 徐力[1] HU Le-lan;GU Xin-fang;XU Li(Department of Laboratory Medicine,Zaozhuang Municipal Hospital,Shandong Zaozhuang 277100)

机构地区：[1]枣庄市立医院检验科,山东枣庄277100

出　　处：《医学检验与临床》2021年第10期41-45,40,共6页Medical Laboratory Science and Clinics

摘　　要：目的:分析2020年山东省枣庄市立医院常见病原菌的分布及耐药性,为临床正确使用抗菌药物提供参考和依据。方法:通过布鲁克MALDI-TOF-MS、BD PhoenixM50自动化仪器鉴定细菌;药敏试验为BD PhoenixM50细菌鉴定/药敏仪器法和纸片扩散法(KB)。药敏按照2020年CLSI M100中规定的折点。结果:2020年1月1日~2020年12月31日全院送检微生物标本16335份,共分离出细菌4925株,阳性分离率为30.1%;前五位病原菌分别是鲍曼不动杆菌1145株(23.2%)、铜绿假单胞菌718株(14.6%)、大肠埃希菌709株(14.4%)、肺炎克雷伯菌685株(13.9%)、金黄色葡萄球菌384株(7.8%)。2020年检出多重耐药菌1339株,占27.2%,主要为耐碳青霉烯类鲍曼不动杆菌(CR-AB)943株检出率82.4%,耐碳青霉烯类铜绿假单胞菌(CR-PA)105株检出率14.6%,甲氧西林耐药金黄色葡萄球菌(MRSA)138株检出率35.9%,耐碳青霉烯类肠杆菌(CRE)46株检出率2.2%。结论:我院甲氧西林耐药金黄色葡萄球菌(MRSA)处于较高水平,耐碳青霉烯的肠杆菌科细菌有所增多,本文根据我院常见病原菌分布及耐药性进行统计分析,监测细菌耐药,监督和指导临床合理使用抗菌药物,预防和减少多重耐药菌。Objective:To analyze the distribution and antimicrobial resistance of common pathogens in Zaozhuang Municipal Hospital,Shandong Province in 2020,and provide reference and basis for the correct use of antimicrobial drugs in clinical practice.Methods:Bacteria identification was performed by Bruker MALDI-TOF-MS,BD PhoenixM50 automated instruments.The BD PhoenixM50 bacterial identification/drug susceptibility instrument method and the disk diffusion method(KB)were used for antimicrobial susceptibility determination.The antimicrobial susceptibility is in accordance with the breakpoint specified in the 2020 CLSI M100.Results:16335 microbial specimens were sent to the hospital for examination from January 1 to December 31,2020.A total of 4925 strains of bacteria were isolated,with a positive isolation rate of 30.1%;the top five pathogenic bacteria were 1145 strains(23.2%)of Acinetobacter baumannii,718 strains(14.6%)of Pseudomonas aeruginosa,709 strains(14.4%)of Escherichia coli,685 strains(13.9%)of Klebsiella pneumoniae,and 384 strains(7.8%)of Staphylococcus aureus.According to the detection results in 2020,1339 strains of multi-drug resistant bacteria,accounting for 27.2%,of which the detection rate of carbapenem-resistant Acinetobacter baumannii(CR-AB)was 82.4%(943 strains),carbapenem-resistant Pseudomonas aeruginosa(CR-PA)was 14.6%(105 strains),methicillin-resistant Staphylococcus aureus(MRSA)was 35.9%(138 strains),and carbapenem-resistant Enterobacter(CRE)was 2.2%(46 strains).Conclusion:Methicillinresistant Staphylococcus aureus(MRSA)in our hospital is at a high level,and carbapenem-resistant Enterobacteriaceae bacteria have also increased.This article conducts statistical analysis based on the distribution and drug resistance of common pathogens,monitors the drug resistance of bacteria,supervises and guides the rational use of antimicrobial drugs in clinical practice,and prevents and reduces multi-drug resistant bacteria.

关 键 词：药敏试验 前五位病原菌 多重耐药菌 耐药性监测分析 

分 类 号：R44[医药卫生—诊断学]