2020—2022年自贡市第一人民医院细菌耐药性监测  

Surveillance of antibiotic resistance in clinical isolates at Zigong First People’s Hospital from 2020 to 2022

作　　者：余建洪[1] 张肃川 陈喻[1] 华浩东 韦英 李健[1] Yu Jianhong;Zhang Suchuan;Chen Yu;Hua Haodong;Wei Ying;Li Jian(Department of Clinical Laboratory,Zigong First People’s Hospital,Zigong 643000)

机构地区：[1]自贡市第一人民医院检验科,自贡643000

出　　处：《中国抗生素杂志》2024年第1期110-119,共10页Chinese Journal of Antibiotics

摘　　要：目的了解自贡市第一人民医院临床分离菌对抗菌药物的耐药性,为临床合理使用抗菌药物提供依据。方法收集我院2020—2022年临床分离菌株,采用VITEK自动化鉴定及药敏系统、纸片扩散法及E-test方法进行细菌鉴定及药物敏感试验,以2022年美国临床和实验室标准化协会(CLSI)折点标准判断结果。结果共分离出临床菌株13324株,其中革兰阴性菌占69.6%,革兰阳性菌占30.4%。前五位分离菌为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌和流感嗜血杆菌。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24.1%和73.0%。耐利奈唑胺屎肠球菌和粪肠球菌的检出率分别为2.1%和12.4%,分离出1株耐万古霉素的屎肠球菌。脑脊液中分离的4株肺炎链球菌均为青霉素非敏感菌株,未检出非脑脊液来源耐青霉素肺炎链球菌。耐碳青霉烯类阴沟肠杆菌的检出率为12.3%。而耐碳青霉烯类大肠埃希菌和肺炎克雷伯菌检出率低,分别为1.1%和2.9%。铜绿假单胞菌对哌拉西林/他唑巴坦、头孢吡肟和庆大霉素的耐药率逐年增加;鲍曼不动杆菌对常见抗菌药物耐药率明显高于铜绿假单胞菌,耐碳青霉烯类菌株检出率分别为41.9%和6.9%。未分离出耐头孢噻肟的流感嗜血杆菌和卡他莫拉菌。结论临床分离菌以革兰阴性菌为主,常见分离菌的耐药率呈现平稳或略有降低的特点。然而,耐利奈唑胺粪肠球菌和耐阿莫西林/克拉维酸流感嗜血杆菌检出率明显升高,应加强医院感染防控措施和抗菌药物的合理使用。Objective This study aimed to investigate antimicrobial resistance in clinical isolates at Zigong First People's Hospital and provide a basis for the rational use of antimicrobial drugs.Methods Clinical isolates from our hospital between 2020 and 2022 were collected.The VITEK automated identification and drug sensitivity system,paper diffusion method,and E-test method were used for bacterial identification and drug sensitivity testing,and the results were judged by the 2022 American Clinical and Laboratory Standardization Institute(CLSI)fold point criteria.Results A total of 13324 clinical strains were isolated,of which Gram-negative bacteria accounted for 69.6% and Gram-positive bacteria accounted for 30.4%.The top five isolates were E.coli,K.pneumoniae,S.aureus,P.aeruginosa,and H.influenzae.The detection rates of methicillin-resistant S.aureus(MRSA)and methicillin-resistant coagulase-negative staphylococci(MRCNS)were 24.1% and 73.0%,respectively.The detection rates of linezolid-resistant E.faecium and E.faecalis were 2.1% and 12.4% of samples,respectively,and one vancomycin-resistant E.faecium strain was isolated.All four strains of S.pneumoniae isolated from cerebrospinal fluid were penicillin-non-susceptible strains,and no penicillin-resistant S.pneumoniae of non-cerebrospinal fluid origin were detected.The detection rate of carbapenem-resistant E.cloacae was 12.3%.The detection rates of carbapenemresistant E.coli and K.pneumoniae were low,at 1.1% and 2.9%,respectively.The resistance rate of P.aeruginosa to piperacillin/tazobactam,cefepime,and gentamicin increased annually;the resistance rate of A.baumannii to common antibacterial drugs was significantly higher than that of P.aeruginosa;and the detection rates of carbapenem-resistant strains were 41.9% and 6.9%,respectively.Cefotaxime-resistant H.influenzae and M.catarrhalis were not isolated.Conclusion Clinical isolates were predominantly Gram-negative bacteria,and the resistance rates of common isolates showed a steady or slightly decreasing pattern.However

关 键 词：细菌耐药监测 药物敏感试验 多重耐药菌 合理用药 

分 类 号：R9[医药卫生—药学]