2020-2023年新疆医科大学附属中医医院细菌耐药性监测  

Surveillance of bacterial resistance in Traditional Chinese Medicine Hospital of Xinjiang Medical University,2020-2023

作　　者：项欣[1] 热孜万姑丽·艾合麦提 魏华 杨丽[1] 尹健[1] 马俊杰[1] 冯雪[1] XIANG Xin;REZEWANGULI Ehmeti;WEI Hua;YANG Li;YIN Jian;MA Junjie;FENG Xue(Department of Laboratory Medicine,Traditional Chinese Medicine Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学附属中医医院检验科,乌鲁木齐830000 [2]新疆医科大学医学工程技术学院

出　　处：《中国感染与化疗杂志》2025年第2期187-194,共8页Chinese Journal of Infection and Chemotherapy

基　　金：新疆维吾尔自治区自然科学基金(2022D01C545)。

摘　　要：目的 了解新疆医科大学附属中医医院临床分离细菌的分布和耐药情况。方法 收集2020 年 1 月 1 日-2023年12 月31 日非重复菌株,采用商品化药敏测试仪和纸片扩散法进行抗菌药物的敏感性试验。按2023年 CLSI M100标准判断药敏结果。结果 四年共监测 22 121株细菌,其中革兰阳性菌 24.1%(5 338株),革兰阴性菌75.9%(16 783株)。葡萄球菌属中,甲氧西林耐药的金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)检出率分别为26.4%和68.9%。MRSA和MRCNS对多数抗菌药物的耐药率均高于甲氧西林敏感株(MSSA和MSCNS);未发现对利奈唑胺或万古霉素耐药的葡萄球菌。肠球菌属中,屎肠球菌对多数测试抗菌药物的耐药率高于粪肠球菌;已发现有个别屎肠球菌对万古霉素耐药,以及个别粪肠球菌对利奈唑胺耐药。287 株肺炎链球菌均为非脑脊液分离株,其中青霉素耐药肺炎链球菌的检出率为9.4%。肠杆菌目细菌中,克雷伯菌属对亚胺培南和美罗培南的耐药率分别为13.2% 和13.1%,但大肠埃希菌和其他菌属对碳青霉烯类的耐药率均低于10.0%。不发酵糖革兰阴性菌中,铜绿假单胞菌对大多测试抗菌药物敏感,对亚胺培南和美罗培南的耐药率分别为11.8%和10.9%;不动杆菌属对亚胺培南和美罗培南的耐药率分别为47.1% 和47.9%,对其他测试抗菌药物的耐药率在14.9%~53.2%。结论 该院临床分离菌株以革兰阴性菌为主。克雷伯菌属对碳青霉烯类药物的耐药率高于肠杆菌目中其他菌属细菌。不动杆菌属对碳青霉烯类药物的耐药率较高。葡萄球菌中甲氧西林耐药菌株的检出率高。肠球菌属中已发现万古霉素耐药株和利奈唑胺耐药株。因此,医院应继续重点关注感染防控和抗菌药物合理应用,遏制耐药细菌的发生和传播。Objective To investigate the distribution and antibiotic resistance of clinical isolates in the Traditional Chinese Medicine Hospital of Xinjiang Medical University.Methods Bacterial strains were collected from January 1,2020,to December 31,2023,and tested for antimicrobial susceptibility using automated systems and disk diffusion methods.The results were interpreted according to the breakpoints recommended in the CLSI M100.Results Over the four-year period,22121 bacterial strains were analyzed,including Gram-positive bacteria(24.1%,5338/22121)and Gram-negative bacteria(75.9%,16783/22121).The prevalence of methicillin-resistant S.aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus(MRCNS)was 26.4%and 68.9%,respectively.MRSA and MRCNS strains showed higher resistance rates to most antimicrobial agents compared to methicillin-susceptible strains(MSSA and MSCNS).No Staphylococcus strains were found resistant to linezolid or vancomycin.E.faecium showed higher resistance rates to most of the antimicrobial agents tested than E.faecalis.A few vancomycin-resistant strains were identified in E.faecium and limited number of linezolid-resistant strains were identified in E.faecalis.All S.pneumoniae isolates were isolated from specimens other than cerebrospinal fluid.The prevalence of penicillin-resistant S.pneumoniae(PRSP)was 9.4%.Overall,13.2%of Klebsiella isolates were resistant to imipenem and 13.1%to meropenem,while the prevalence of carbapenem-resistant strains was less than 10%in Escherichia coli or other genera of Enterobacterales.As for non-fermenting Gram-negative bacteria,P.aeruginosa was largely susceptible to most antimicrobial agents.Overall,11.8%and 10.9%of P.aeruginosa strains were resistant rates to imipenem and meropenem,respectively.However,47.1%of Acinetobacter strains were resistant to imipenem and 47.9%to meropenem,while 14.9%to 53.2%of the strains were resistant to other antimicrobial agents tested.Conclusions The clinical strains isolated in the Traditional Chinese Medicine Hospital

关 键 词：细菌耐药性监测 药物敏感性试验 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]