2018—2020年泉州市第一医院细菌耐药性监测  

Surveillance of bacterial resistance in Quanzhou Municipal First Hospital from 2018 to 2020

作　　者：何秀华[1] 朱焱[1] 杨鹏雅[1] 马翠苹 郑怡娟 王星 刘江福 HE Xiuhua;ZHU Yan;YANG Pengya;MA Cuiping;ZHENG Yijuan;WANG Xing;LIU Jiangfu(Department of Infectious Diseases,Quanzhou Municipal First Hospital,Quanzhou Fujian 362000,China)

机构地区：[1]泉州市第一医院感染科,福建泉州362000

出　　处：《中国感染与化疗杂志》2022年第4期454-462,共9页Chinese Journal of Infection and Chemotherapy

基　　金：福建省卫生厅青年科研基金(2018-1-95)。

摘　　要：目的了解2018年1月—2020年12月泉州市第一医院临床分离菌对常见抗菌药物的敏感性和耐药性。方法采用自动化仪器法、纸片扩散法及E试验法按CHINET统一监测方案进行药物敏感性试验。按CLSI 2020年版标准判断结果。结果2018-2020年该院共收集临床分离菌14391株,其中革兰阳性菌4260株,占29.6%,革兰阴性菌10131株,占70.4%。金黄色葡萄球菌和凝固酶阴性葡萄球菌中甲氧西林耐药株(MRSA和MRCNS)的平均检出率分别为19.9%、58.2%。MRSA和MRCNS对所测试药物的耐药率均显著高于甲氧西林敏感株(MSSA和MSCNS),未发现万古霉素耐药株。除利奈唑胺和替考拉宁外,粪肠球菌对绝大多数测试抗菌药物的耐药率均显著低于屎肠球菌,未检出耐万古霉素的肠球菌。肺炎链球菌非脑膜炎株成人株和儿童株中青霉素不敏感株(PNSP)的检出率有所下降。肠杆菌目细菌对碳青霉烯类仍高度敏感,耐药率低于7.5%。碳青霉烯类耐药肺炎克雷伯菌(CRKP)检出率0.6%(39/6606)。铜绿假单胞菌对碳青霉烯类抗生素外的大多数测试抗菌药物的耐药率均有所下降。鲍曼不动杆菌株数明显下降,对替加环素、多黏菌素B耐药率有所上升,对其他测试药物的耐药率均有下降,但耐药率仍在40%以上。结论细菌耐药性监测三年间,碳青霉烯类耐药的肠杆菌目细菌呈缓慢上升趋势,应加强医院感染防控措施和抗菌药物临床应用管理措施。Objective To investigate the susceptibility and resistance profile of clinical isolates collected from Quanzhou Municipal First Hospital from January 2018 to December 2020.Methods Antimicrobial susceptibility testing was carried out according to CHINET unified protocol using Kirby-Bauer method,automated systems,and E-test method.Results were interpreted according to the breakpoints recommended by the Clinical and Laboratory Standards Institute in 2020.Results A total of 14391 nonduplicate isolates were collected from 2018 to 2020,including gram-positive microorganisms(29.6%,4260/14391)and gram-negative bacteria(70.4%,10131/14391).Methicillin-resistant strains accounted for an average of 19.9%in S.aureus(MRSA)and 58.2%in coagulase-negative Staphylococcus(MRCNS).MR strains showed much higher resistance rates to most of the antimicrobial agents tested than MS strains.No staphylococcal strains were found resistant to vancomycin.E.faecalis strains showed much lower resistance rates to most of the drugs tested(except for linezolid and teicoplanin)than E.faecium.No enterococcal strains were found resistant to vancomycin.The proportion of penicillin-nonsusceptible S.pneumoniae(PNSP)strains in the non-meningitis S.pneumoniae strains isolated from both adults and children decreased.Enterobacterales strains were still highly susceptible to carbapenems.Overall,less than 7.5%of these strains were resistant to carbapenems.The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKP)was 0.6%(39/6606).Pseudomonas aeruginosa strains showed decreasing resistance rates to most of the antimicrobial agents except carbapenems.The number of Acinetobacter baumannii strains decreased significantly,but showed increasing resistance rates to tigecycline and polymyxin B,and decreasing resistance rates to other antimicrobial agents tested(but still>40%).Conclusions Surveillance of bacterial resistance for 3 years in our hospital suggests that carbapenemresistant Enterobacterales are still on the rise.It is necessary to strengthen hospita

关 键 词：细菌耐药性监测 抗菌药物 药物敏感性试验 

分 类 号：R378[医药卫生—病原生物学]