某三甲医院2017-2021年细菌耐药率监测分析  

Surveillance of antimicrobial resistance in a third-grade general hospital in 2017-2021

作　　者：全念 唐朋 黄微微 张立群 QUAN Nian;TANG Peng;HUANG Weiwei;ZHANG Liqun(Department of Clinical Laboratory,the Second Affiliated Hospital of the Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院检验科,重庆400037

出　　处：《国际检验医学杂志》2022年第17期2053-2059,共7页International Journal of Laboratory Medicine

基　　金：国家自然科学基金项目(1873981);重庆市技术创新与应用示范项目(cstc2018jscx-msybx0060)。

摘　　要：目的分析该院2017-2021年临床细菌分离株的分布及对常用抗菌药物的耐药情况,为临床合理用药提供依据。方法收集近5年门诊和住院患者培养标本分离的病原菌,采用标准纸片扩散法或自动化仪器检测法进行药敏试验,对细菌耐药监测数据进行统计分析。结果共分离细菌24177株,革兰阳性菌占32.9%,革兰阴性菌占67.1%。居前五位的是大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球、铜绿假单胞菌、凝固酶阴性葡萄球菌。其中大肠埃希菌、肺炎克雷伯菌对碳青霉烯类抗菌药物的耐药率分别为0.4%~1.8%和18.3%~35.0%。铜绿假单胞菌、鲍曼不动杆菌对亚胺培南的耐药率分别为12.9%~20.9%、82.9%~87.8%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为24.8%和64.4%。屎肠球菌对氨苄西林、红霉素、呋喃妥因、氟喹诺酮类抗菌药物的耐药率均高于粪肠球菌,差异有统计学意义(P<0.01)。结论在应对耐药菌的威胁时,应加强抗菌药物的合理使用,采取有效的医院感染控制措施,减少耐药菌的产生及传播。Objective To investigate the distribution and antimicrobial resistance of clinical bacterial strains from 2017 to 2021,and provide basis for clinical rational use of antimicrobial agents.Methods Strains isolated from cultured specimens of outpatients and inpatients in recent 5 years were collected,antimicrobial susceptibility testing was performed by Kirby-Bauer method or automated system,bacterial resistance monitoring data was analyzed statistically.Results A total of 24177 bacterial strains were isolated,32.9%for gram-positive bacteria and 67.1%for gram-negative bacteria.The top five isolated bacteria were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Pseudomonas aeruginosa,Coagulase-negative Staphylococcus.Resistance rates of Escherichia coli and Klebsiella pneumoniae to carbapenems were 0.4%-1.8%and 18.3%-35.0%respectively.Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 12.9%-20.9%and 82.9%-87.8%.Detection rates of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus(MRCNS)were 24.8%and 64.4%respectively.Resistance rates of Enterococcus faecium to ampicillin,erythromycin,nitrofurantoin and fluoroquinolones were all higher than those of Enterococcus faecalis(P<0.01).Conclusion In dealing with the threat of drug-resistant bacteria,it is necessary to strengthen the rational use of antimicrobial agents,take effective measures to control healthcare-associated infection,and reduce the emergence and spread of drug-resistant bacteria.

关 键 词：细菌耐药率监测 病原菌 抗菌药物 抗药性 

分 类 号：R446.5[医药卫生—诊断学]