2012~2020年某院新生儿病区细菌分布及耐药率变迁  

Changes of Bacterial Distribution and Antimicrobial Resistance Rate in Neonatal Ward of a Hospital from 2012 to 2020

作　　者：陈培培 林汉杰[2] 邱世洁 郑芬 余楠[1,3] Chen Peipei;Lin Hanjie;Qiu Shijie;Zheng Fen;Yu Nan(Department of Laboratory Medicine,Zhujiang Hospital of Southerm Medical University,Guangzhou 510000,China;Foshan Maternity&Child Healthcare Hospital;School of Laboratory and Biotechnology,Southern Medical University)

机构地区：[1]南方医科大学珠江医院检验医学部,广州510000 [2]佛山市妇幼保健院检验科 [3]南方医科大学检验与生物技术学院

出　　处：《药物流行病学杂志》2021年第12期810-814,共5页Chinese Journal of Pharmacoepidemiology

基　　金：国家重大科技专项课题项目(编号:2017ZX10103011-006)。

摘　　要：目的:了解佛山市妇幼保健院2012~2020年新生儿病区临床分离菌的分布及耐药率变迁,为临床合理用药提供依据。方法:采用回顾性分析方法,将本院新生儿病区2012~2020年临床分离菌数据按时间顺序分为3组,即2012~2014年为A组,2015~2017年为B组,2018~2020年为C组,统计分析3组检出菌分布及药敏结果,并进行耐药率变迁分析。结果:本院新生儿病区2012~2020年共分离出1723株细菌,前4位分别为肺炎克雷伯菌属(379株,22.00%)、凝固酶阴性葡萄球菌(323株,18.75%)、金黄色葡萄球菌(239株,13.87%)和大肠埃希菌(238株,13.81%)。9年间未检出对万古霉素、替考拉宁、利奈唑胺耐药的金黄色葡萄球菌,且金黄色葡萄球菌对利福平、四环素和克林霉素耐药率呈下降趋势。共检出耐甲氧西林金黄色葡萄球菌(MRSA)54株,3组间检出率差异有统计学意义(P<0.05),B组检出率较A、C两组显著增加(P<0.05/3)。9年间未检出耐碳青霉烯类大肠埃希菌,但大肠埃希菌对头孢菌素类和氟喹诺酮类等抗菌药物的耐药率呈上升趋势。共检出耐碳青霉烯类克雷伯菌属(CR-KP)40株,B组克雷伯菌对碳青霉烯类药物的耐药率显著高于A组和C组(P<0.05/3)。结论:凝固酶阴性葡萄球菌、无乳链球菌等菌株,及多重耐药菌如MRSA、CR-KP等在2018~2020年检出率较前下降,提示应继续加强医院感染防控及抗菌药物合理应用的管理,做好耐药监测工作,指导临床合理使用抗菌药物。Objective:To investigate the changes of bacterial distribution and antibiotic resistance rate in neonatal ward of Foshan Maternity and Child Healthcare Hospital from 2012 to 2020 and provide reference for clinical treatment.Methods:The clinical isolated bacteria from January 2012 to December 2020 were divided into three groups according to the time sequence,group A from 2012 to 2014,group B from 2015 to 2017 and group C from 2018 to 2020.The distribution and antibiotic resistance of the three groups were analyzed retrospectively,and the change of antibiotic resistance rate was analyzed by statistical method.Results:1723 strains of pathogens were isolated from neonatal ward and the top-four pathogens were as follows,Klebsiella spp.(379,22.00%),Coagulase-negative Staphylococcus(CONS)(323,18.75%),Staphylococcus aureus(S.aureus)(239,13.87%),and Escherichia coli(E.coli)(238,13.81%).No S.aureus resistant to vancomycin,teicoplanin and linezolid was detected in 9 years.Resistance rates of the S.aureus to rifampin,tetracycline and clindamycin decreased.A total of 54 MRSA strains were detected,and difference were all statistically significant in three groups(P<0.05),and group B significantly increased compared with group A and group C(P<0.05/3).There was no carbapenem resistant E.coli within 9 years.The resistance rate of E.coli to cephalosporins and fluoroquinolones was on the rise.A total of 40 strains of carbapenem resistant Klebsiella spp.(CR-KP)were detected.The resistance rate of group B to carbapenem was significantly higher than that of group A and group C(P<0.05/3).Conclusion:The detection rate of CONS,GBS and other strains decreased in 2018-2020,and the detection rate of multi drug resistant bacteria such as MRSA and cr-kp decreased in 2018-2020.We should continue to strengthen the management of nosocomial infection prevention and control and rational application of antibiotics,do a good job in drug resistance monitoring,and guide the rational use of antibiotics in clinic.

关 键 词：新生儿 细菌分布 耐药率 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]