2016—2018年安徽省铜陵市细菌耐药性监测  

Surveillance of bacterial resistance in Tongling city, Anhui province, 2016-2018

作　　者：黄丽 林建[2] 宋有良[2] 潘晓龙[2] 周东升[2] 钱泽平 刘三保 陈自武 朱向阳 Huang Li;Lin Jian;Song You-liang;Pan Xiao-long;Zhou Dong-sheng;Qian Ze-ping;Liu San-bao;Chen Zi-wu;Zhu Xiang-yang(Tongling Municipal Hospital,Tongling 244000;Tongling People's Hospital,Tongling 244000;The Fourth People's Hospital,Tongling 244000;The Second People's Hospital,Tongling 244000;Tongling Hospital of Traditional Chinese Medicine,Tongling 244000;The Fifth People's Hospital,Tongling 244000)

机构地区：[1]铜陵市立医院,铜陵244000 [2]铜陵市人民医院,铜陵244000 [3]铜陵市第四人民医院,铜陵244000 [4]铜陵市第二人民医院,铜陵244000 [5]铜陵市中医院,铜陵244000 [6]铜陵市第五人民医院,铜陵244000

出　　处：《中国抗生素杂志》2022年第3期295-303,共9页Chinese Journal of Antibiotics

基　　金：安徽省临床医学应用技术项目(No.008A058)。

摘　　要：目的 了解2016—2018年安徽省铜陵市临床分离菌株分布特点及对抗菌药物的耐药性变迁。方法 按照统一标准方案,采用纸片扩散法(K-B法)或自动化仪器法对2016—2018年临床分离的细菌进行药物敏感性试验,依据2018年CLSI标准判读结果;采用WHONET5.6软件统计分析。结果 2016—2018年铜陵市共收集非重复菌株12216株,其中革兰阴性菌9147株(74.9%),革兰阳性菌3069株(25.1%)。前5位的细菌依次是大肠埃希菌(20.2%),克雷伯菌属(17.6%)、不动杆菌属(12.8%)、铜绿假单胞菌(11.7%)、凝固酶阴性葡萄球菌(8.5%)。耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌(MRSA和MRCNS)的平均检出率为25.5%和66.2%;未发现万古霉素和利奈唑胺耐药的葡萄球菌属。万古霉素耐药屎肠球菌检出率为2.5%,未检出万古霉素耐药的粪肠球菌。2016—2018年耐碳青霉烯类革兰阴性杆菌检出率呈逐年上升趋势。其中,耐碳青霉烯类肺炎克雷伯菌(CRKP)的历年检出率分别为25.5%、34.6%和41.1%;耐碳青霉烯类鲍曼不动杆菌(CRAB)分别为74.7%、84.5%、85.3%;耐碳青霉烯类铜绿假单胞菌(CRPA)分别为25.3%、27.6%和30.1%。结论 细菌耐药状况日趋严重,多重耐药菌株尤其是耐碳青霉烯类革兰阴性菌的检出率持续上升,应引起感染控制部门的重视。Objective To understand the distribution and the changing patterns of antibacterial resistance among clinical isolates in Tongling city, Anhui province from 2016 to 2018. Methods The disk-diffusion method(K-B method) and the automated instrument method were used to test the drug susceptibility of bacteria strains isolated from clinical settings from 2016 to 2018. The results were interpreted according to the 2018 CLSI standard.The statistical analysis was performed using the WHONET5.6 software. Results A total of 12,216 non-repeating strains were collected in Tongling city from 2016 to 2018, including 9147(74.9%) Gram-negative bacteria and 3069(25.1%) Gram-positive bacteria. The top 5 most frequently isolated micro-organisms were Escherichia coli(20.2%),Klebsiella spp(17.5%), Acinetobacter spp(12.8%), Pseudomonas aeruginosa(11.7%), and coagulase-negative Staphylococcus(8.5%). MRSA and MRCNS accounted for 25.5% and 66.2%, respectively. No staphylococcal strains were found resistant to vancomycin or linezolid. The ratio of vancomycin-resistant Enterococcus faecium was 2.5%,and no vancomycin-resistant Enterococcus faecalis was detected. The detection rate of carbapenem-resistant Gramnegative bacilli in 2016-2018 has been increasing year by year. From 2016 to 2018, Carbapenem-resistant Klebsiella pneumoniae(CRKP) was 25.5%, 34.6%, and 41.1%, respectively;carbapenem-resistant Acinetobacter baumannii(CRAB) was 74.7%, 84.5%, and 85.3%, respectively;carbapenem-resistant Pseudomonas aeruginosa(CRPA) was 25.3%, 27.6%, and 30.1%, respectively. Conclusions Current state of antibiotic resistance in Tongling is still very serious. The detection rate of multiple drug-resistant strains, especially carbapenem-resistant Gram-negative bacteria,continues to rise, which should attract the attention of infection control departments.

关 键 词：细菌耐药性 抗菌药物 广泛耐药 耐碳青霉烯类革兰阴性菌 

分 类 号：R978.1[医药卫生—药品]