2022年西安交通大学第一附属医院细菌耐药性监测  

Surveillance of antimicrobial resistance in the First Affiliated Hospital of Xi’an Jiaotong University in 2022

作　　者：贺侠琴 杨青青[1] 王晓倩 刘梦 李雯[1] 曾晓艳[1] HE Xiaqin;YANG Qingqing;WANG Xiaoqian;LIU Meng;LI Wen;ZENG Xiaoyan(Department of Laboratory Medicine,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院检验科,西安710061

出　　处：《中国感染与化疗杂志》2024年第5期581-587,共7页Chinese Journal of Infection and Chemotherapy

基　　金：陕西省重点研发计划(2021SF-019)。

摘　　要：目的了解西安交通大学第一附属医院2022年临床分离菌的分布及对抗菌药物的耐药性,为临床抗菌药物的合理应用提供参考依据。方法回顾性收集该院2022年1月1日—12月31日临床分离的非重复细菌,采用纸片扩散法、全自动仪器法进行体外抗菌药物敏感性试验,按2021年CLSI文件标准判读结果,用WHONET 5.6软件进行数据分析。结果共分离细菌8638株,革兰阴性菌60.8%(5253/8638),革兰阳性菌39.2%(3385/8638)。葡萄球菌属中甲氧西林耐药金黄色葡萄球菌(MRSA)、表皮葡萄球菌(MRSE)、其他凝固酶阴性葡萄球菌(MRCNS)的检出率分别为33.0%、75.8%、51.9%,未发现万古霉素耐药株。肠球菌属中屎肠球菌万古霉素耐药株的检出率为0.6%,粪肠球菌中未发现万古霉素耐药株,粪肠球菌对利奈唑胺的耐药率(5.2%)高于屎肠球菌(0.7%)。碳青霉烯类耐药肠杆菌目细菌的检出率为7.9%,其中肺炎克雷伯菌和大肠埃希菌耐药株检出率分别为12.1%和1.6%。碳青霉烯类耐药的铜绿假单胞菌和鲍曼不动杆菌检出率分别30.9%和77.0%。结论细菌耐药形势严峻,临床应加强医院感染部位的标本送检,提高病原菌学的诊断能力及耐药性监测,助力临床合理使用抗菌药物,减少多重耐药菌的进一步蔓延。Objective To investigate the distribution and antimicrobial resistance of clinical isolates in the First Affiliated Hospital of Xi'an Jiaotong University in 2022 for rational use of antibiotics in clinical practice.Methods Nonduplicate clinical isolates were collected from January 1,2022 to December 31,2022.Antimicrobial susceptibility testing was carried out using Kirby-Bauer method and automated systems.The data were analyzed using WHONET 5.6 software and interpreted according to the Clinical and Laboratory Standards Institute(CLSI)breakpoints(2021 Edition).Results Of the 8638 clinical isolates,gram negative bacteria and gram positive bacteria accounted for 60.8%(5253/8638)and 39.2%(3385/8638),respectively.The prevalence of methicillin-resistant strains was 33.0%in S.aureus(MRSA),75.8%in S.epidermidis(MRSE),and 51.9%in other coagulase-negative Staphylococcus(MRCNS).No staphylococcal strains were found resistant to vancomycin.The prevalence of vancomycin-resistant E.faecium was 0.6%,and no vancomycin-resistant E.faecalis was found.E.faecalis strains showed higher resistance rate to linezolid(5.2%)than E.faecium(0.7%).The prevalence of carbapenem-resistant Enterobacterales(CRE)was 7.9%,specifically 12.1%for carbapenem-resistant K.pneumoniae(CRKP)and 1.6%for carbapenem-resistant E.coli(CREC).The prevalence of carbapenem-resistant P.aeruginosa(CRPA)and carbapenem-resistant A.baumannii(CRAB)was 30.9%and 77.0%,respectively.Conclusions Clinical microbiology laboratories should strengthen the collection and testing of clinical specimens from the sites of infection in order to improve pathogenic diagnosis and antimicrobial resistance surveillance.This is conducive to the rational use of antibiotics and reduce the further spread of multidrug-resistant bacteria.

关 键 词：细菌耐药性监测 抗菌药物 药敏试验 甲氧西林耐药金黄色葡萄球菌 碳青霉烯类耐药革兰阴性菌 

分 类 号：R378[医药卫生—病原生物学]