2017-2020年新疆某医院细菌分布及耐药分析  

Analysis of bacterial distribution and drug resistance in a hospital in Xinjiang from 2017 to 2020

作　　者：孔焱 王辉 李岩 贾雪芝 王福刚 宋兴勃[2] 李冬冬[2] KONG Yan;WANG Hui;LI Yan;JIA Xuezhi;WANG Fugang;SONG Xingbo;LI Dongdong(Department of Clinical Laboratory,Karamay Hospital of Integrated Traditional Chinese and Western Medicine(Karamay People's Hospital),Karamay,Xinjiang 834000,China;Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]新疆维吾尔自治区克拉玛依市中西医结合医院(市人民医院)检验科,新疆克拉玛依834000 [2]四川大学华西医院实验医学科,四川成都610041

出　　处：《国际检验医学杂志》2022年第17期2141-2145,2151,共6页International Journal of Laboratory Medicine

摘　　要：目的了解克拉玛依市中西医结合医院(市人民医院)(下称该院)2017-2020年临床分离菌株的分布及抗菌药物的耐药情况,为临床合理用药提供依据。方法纳入2017-2020年该院所有临床分离菌株,采用VITEK2全自动微生物分析系统进行鉴定及药敏实验,按照CLSI标准判读。结果2017-2020年共纳入非重复菌株2682株,其中革兰阳性菌919株(34.3%),革兰阴性菌1763株(65.7%)。排前5位的菌株为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌、鲍曼不动杆菌。耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)检出率为13.9%和66.2%。MRSA和MRCNS耐药率明显高于甲氧西林敏感的金黄色葡萄球菌(MSSA)和凝固酶阴性葡萄球菌(MSCNS),未检出对万古霉素、利奈唑胺耐药的葡萄球菌,未检出耐万古霉素的肠球菌。产超广谱β-内酰胺酶(ESBL)大肠埃希菌和肺炎克雷伯菌检出率分别为40.5%和13.6%,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星高度敏感,未发现耐碳青霉烯类药物菌株。亚胺培南对铜绿假单胞菌、鲍曼不动杆菌的耐药率为6.7%和5.9%。结论该院2017-2020年分离的病原菌耐药呈上升趋势,尤其是耐碳青霉烯类铜绿假单胞菌和鲍曼不动杆菌,以及耐喹诺酮类大肠埃希菌。应加强细菌耐药科学管理及合理用药指导。Objective To understand the distribution of clinical isolates and antimicrobial resistance in Karamay Hospital of Integrated Traditional Chinese and Western Medicine(People′s Hospital)from 2017 to 2020,and to provide a basis for clinical rational drug use.Methods All clinical isolates in the hospital from 2017 to 2020 were included,and the VITEK2 automatic microbiological analysis system was used for identification and drug susceptibility experiments,and the results were interpreted according to the CLSI standard over the years.Results From 2017 to 2020,a total of 2682 non-repetitive strains were included,including 919 strains Gram-positive bacteria(34.3%)and 1763 strains Gram-negative bacteria(65.7%).The top five strains were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,coagulase-negative staphylococcus,and Acinetobacter baumannii.The detection rates of methicillin-resistant Staphylococcus aureus(MRSA)and coagulase-negative staphylococcus(MRCNS)were 13.9%and 66.2%.The resistance rates of MRSA and MRCNS were significantly higher than those of methicillin-sensitive Staphylococcus aureus(MSSA)and coagulase-negative staphylococcus(MSCNS).No Staphylococcus strains resistant to vancomycin and linezolid have been found,and no Enterococcus strains resistant to vancomycin have been found.The detection rates of extended-spectrumβ-lactamase(ESBL)-producing Escherichia coli and Klebsiella pneumoniae were 40.5%and 13.6%,respectively,which were highly sensitive to cefoperazone/sulbactam,piperacillin/tazobactam and Amikacin,and no carbapenem-resistant strains have been found.The resistance rates of imipenem to Pseudomonas aeruginosa and Acinetobacter baumannii were 6.7%and 5.9%,respectively.Conclusion The drug resistance of pathogens isolated from Karamay People′s Hospital from 2017 to 2020 shows an upward trend,especially carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii,and quinolone-resistant Escherichia coli.Scientific management of bacterial resistance and guidance on rational dr

关 键 词：菌株分布 耐药分析 合理用药 多重耐药 

分 类 号：R446.5[医药卫生—诊断学]