2019年度华西检验学科联盟医院细菌耐药监测分析  

Monitoring and Analysis of Bacterial Resistance in Hospitals of West China Laboratory Science Union Network(WMNet)in 2019.

作　　者：罗军[1] 何超[2] 王远芳[2] 康梅[2] Luo Jun;He Chao;Wang Yuanfang(Department of Clinical Laboratory,Mianyang Central Hospital,Mianyang,Sichuan 621000;Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China.)

机构地区：[1]四川省绵阳市中心医院检验科,四川绵阳621000 [2]四川大学华西医院实验医学科,四川成都610041

出　　处：《四川医学》2021年第12期1237-1244,共8页Sichuan Medical Journal

摘　　要：目的回顾分析2019年度华西检验学科联盟网(WMNet)19家三级综合医院细菌分离株的耐药情况。方法采用WHONET 5.6软件分析19家成员单位上报的监测数据,依据CLSI 2019年标准判断药敏结果。结果2019年共分离菌株68260株,其中革兰阴性菌47150株,占69.1%;革兰阳性菌21110株,占30.9%。检出细菌排在前5位的分别是:大肠埃希菌(17.4%)、流感嗜血杆菌(13.5%)、肺炎克雷伯菌(10.3%)、金黄色葡萄球菌(9.9%)和肺炎链球菌(7.8%)。菌株主要来源于痰液(55.0%)、尿液(11.6%)、分泌物(10.4%)和血液(7.2%)。金黄色葡萄球菌中甲氧西林耐药菌株的检出率为31.9%。屎肠球菌对大多数抗菌药物的耐药率均高于粪肠球菌,两者均出现万古霉素耐药菌株(耐药率分别为0.2%和0.1%)。流感嗜血杆菌β-内酰胺酶阳性率为82.6%,对复方磺胺甲噁唑的耐药率为62.9%。大肠埃希菌和肺炎克雷伯菌超广谱β-内酰胺酶阳性检出率分别为50.1%和23.6%,碳青霉烯类药物对大肠埃希菌仍保持较高的抗菌活性,对亚胺培南和美罗培南的敏感率分别为98.2%和98.4%。肺炎克雷伯菌对碳青霉烯类药物的耐药率呈缓慢上升趋势,其中对亚胺培南和美罗培南的耐药率分别为9.2%和12.1%。铜绿假单胞菌和鲍曼不动杆菌对美罗培南的耐药率分别为6.9%和48.9%。结论临床分离株以革兰阴性菌居多,多重耐药菌的检出日益增多,应加强院感防控和对抗菌药物的管理,做好耐药监测工作。Objective To investigate the bacterial drug resistance profiles of the clinical strains isolated from 19 tertiary hospitals of West China Laboratory Science Union Network(WMNet)in 2019.Methods The surveillance data reported by 19 member institutions were analyzed with WHONET 5.6 software.The results of drug sensitivity were determined according to CLSI 2019 breakpoints.Results A total of 68260 strains of bacteria were isolated in 2019,of which gram-negative and gram-positive organisms accounted for 69.1%and 30.9%,respectively.The top 5 bacteria were Escherichia coli(17.4%),Haemophilus influenzae(13.5%),Klebsiella pneumoniae(10.3%),Staphylococcus aureus(9.9%)and Streptococcus pneumoniae(7.8%).The strains were mainly derived from sputum(55.0%),urine(11.6%),secretions(10.4%)and blood(7.2%).Methicillin-resistant strains in S.aureus(MRSA)was 31.9%.E.faecium strains demonstrated much higher resistance rates to most of the drugs tested than that of E.faecalis.A few strains of both species were resistant to vancomycin(resistance rates were 0.2%and 0.1%,respectively).The positive rate ofβ-lactamase in H.influenzae strains was 82.6%,and the resistance rate to trimethoprim-sulfamethoxazole was 62.9%.The incidence of extended-spectrumβ-lactamase positive E.coli and K.pneumoniae was 50.1%and 23.6%,respectively.The susceptibility of E.coli to imipenem and meropenem were 98.2%and 98.4%,respectively.The drug resistance rates of Klebsiella pneumoniae to carbapenems showed a slow increasing trend,and the drug resistance rates to imipenem and meropenem were 9.2%and 12.1%,respectively.About 6.9%and 48.9%of P.aeruginosa and A.baumannii strains were resistant to meropenem,respectively.Conclusion Most of the clinical isolates are gram-negative bacteria,and the detection of multi-drug resistant bacteria is increasing.Therefore,the prevention and control of nosocomial infection and the management of antibiotics should be strengthened.The monitoring of antimicrobial resistance surveillance should be conducted in a good manner.

关 键 词：细菌 耐药性 监测 检出率 

分 类 号：R378[医药卫生—病原生物学]