2021年度上海某三甲医院细菌耐药性分析  

Analysis on drug resistance of bacterials in a tertiary hospital in Shanghai in 2021

作　　者：俞岚 汤荣[1] 廖焕金 YU Lan;TONG Rong;LIAO Huanjin(Shanghai General Hospital,Shanghai 200080,China)

机构地区：[1]上海市第一人民医院,上海200080

出　　处：《国际检验医学杂志》2023年第S01期110-114,共5页International Journal of Laboratory Medicine

基　　金：上海市第一人民医院院内感染项目(SYYG20221003,SYYG20221017);上海市“科技创新行动计划”启明星项目(22YF1435600)。

摘　　要：目的分析该院2021年分离菌株特点和对常用抗菌药物的耐药性,指导临床用药和对患者的护理。方法收集2021年1-12月该院痰液、尿和血等样本分离的菌株,依据CLSI M100-S31版的药物敏感折点进行评价,统计分析菌株种类、分布和耐药特点。结果分离得到非重复病原菌4792株,其中革兰阳性菌占29.6%(1418株),革兰阴性菌占70.4%(3374株),以大肠埃希菌、克雷伯菌属、肠球菌属和金黄色葡萄球菌为主。产ESBLs肠杆菌科中,克雷伯菌属的检出率为40.8%(305株),大肠埃希菌的检出率为62.5%(616株),奇异变形杆菌检出率为58.3%(126株)。碳青霉烯耐药铜绿假单胞菌检出率为22.5%(95株),碳青霉烯耐药鲍曼不动杆菌检出率为40.6%(104株)。MRSA和MRCNS检出率分别为57.6%(257株)和78.4%(80株),未检测到耐万古霉素肠球菌。结论多重耐药株检出率仍居高不下,需继续加强抗菌药敏监测,为临床合理选择抗菌药物提供依据。Objective To analyze the distribution of isolated bacterial from Shanghai general hospital in 2021 and the drug resistance to commonly used antibacterial drugs,and to guide clinical medication and patient care.Methods The clinical data of bacterial strains were collected from the sputum,urine and blood samples in Shanghai general hospital ward from January to December 2021.The strain species,distribution and resistance characteristics were statistically analyzed according to CLSI M100-S31.Results There were 4,792 strains of non-repetitive pathogens were isolated,of which the gram-positive bacteria accounted for 29.6%(1418 strains)and the gram-negative bacteria accounted for 70.4%(3374 strains),dominated by escherichia coli,klebsiella,enterococcus and staphylococcus aureus.The prevalence of ESBLs producing strains were 40.8%(305 strains)in Klebsiella spp,62.5%(616 strains)in E.coli spp,and 58.3%(126 strains)in proteus mirabilis.The rate of carbapenem-resistant pseudomonas aeruginosa was 22.5%(95 strains)and that of acinetobacter baumannii resistance was 40.6%(104 strains).The MRSA and MRCNS detection rates were 57.6%(257 strains)and 78.4%(80 strains)respectively,and vancomycin-resistant enterococcus were not detected.Conclusion The rate of multi-resistant strains remains high,and it is necessary to continue to strengthen bacterial resistance surveillance to provide a basis for rational clinical selection of antibacterial drugs.

关 键 词：细菌耐药性监测 药物敏感性 多重耐药 

分 类 号：R446.5[医药卫生—诊断学]