2020-2022年广西柳州市工人医院细菌耐药性监测  

Surveillance of bacterial resistance in Liuzhou Workers’Hospital,Guangxi from 2020 to 2022

作　　者：李梦薇[1] 韦柳华[1] 罗国兰[1] 朱虹贞[1] 林盛张 陈丽坤 蒋利君[1] 王海霞 LI Mengwei;WEI Liuhua;LUO Guolan;ZHU Hongzhen;LIN Shengzhang;CHEN Likun;JIANG Lijun;WANG Haixia(Department of Laboratory Medicine,the Fourth Affiliated Hospital of Guangxi Medical University,Liuzhou Workers’Hospital,Liuzhou Guangxi 545005,China)

机构地区：[1]广西医科大学第四附属医院柳州市工人医院医学检验科,广西柳州545005

出　　处：《中国感染与化疗杂志》2025年第2期195-202,共8页Chinese Journal of Infection and Chemotherapy

基　　金：广西壮族自治区卫生健康委员会自筹课题(Z20200152)。

摘　　要：目的 了解2020-2022年连续3年广西柳州市工人医院临床分离菌对常见抗菌药物的耐药性与敏感性。方法 使用VITEK-2 Compact或纸片扩散法或E试验法进行药敏试验,参照CLSI M100 32^(nd) 2022年版药敏折点标准判读结果,采用WHONET 5.6软件进行分析。结果 该院共收集到临床分离株26 254株,其中革兰阳性菌27.9%,革兰阴性菌72.1%。甲氧西林耐药葡萄球菌MRSA和MRCNS的检出率分别为20.0%和 72.2%。甲氧西林耐药株(MRSA和MRCNS)对大多数抗菌药物耐药率高于甲氧西林敏感株(MSSA和MSCNS);未发现有万古霉素、利奈唑胺和替加环素的耐药菌株。屎肠球菌对大多常用抗菌药物耐药率普遍高于粪肠球菌,均未发现两者对万古霉素耐药的菌株,但有少数菌株对利奈唑胺耐药。非脑膜炎肺炎链球菌中儿童株和成人株分别为691株和123株;两组菌株中PRSP分别为0.4%和1.6%,但均未发现有中介株。耐碳青霉烯类肺炎克雷伯菌(CRKpn)的检出率三年间分别为1.2%、1.2%、13.8%;而铜绿假单胞菌和鲍曼不动杆菌中耐碳青霉烯类菌株(CRPae 和CRAba)三年间分别为10.7%、17.5%、14.3%和68.4%、75.2%、77.3%。1 269株流感嗜血杆菌中儿童株和成人株各为84.6%和15.4%,两组菌株中β内酰胺酶的检出率分别为39.4%和46.8%;产酶株对氨苄西林耐药,但在不产酶株中已经发现有少数的氨苄西林耐药(BLNAR)株,其检出率为27.0%。结论 该院细菌对抗菌药物的耐药形势严峻,尤其是碳青霉烯类耐药革兰阴性杆菌(CRO)菌株的检出率较高,应加强院感防控措施和临床抗菌药物管理,及CRO的主动筛查。临床应多送检疑似感染部位的标本,在药敏报告发出前首先经验用药,待收到药敏报告后,再根据药敏报告合理选用抗菌药物。Objective To understand the changing profiles of antimicrobial susceptibility of the bacterial strains isolated from patients at Liuzhou Workers'Hospital in Guangxi from 2020 to 2022.Methods The bacteria were isolated,identified,and underwent antimicrobial susceptibility testing using VITEK 2 Compact,disk diffusion method,or E-test.The results were interpreted nd according to the breakpoints recommended by CLSI M10032 Edition in 2022.The data were analyzed using WHONET 5.6 software.Results A total of 26254 nonduplicate strains were collected from 2020 to 2022,including Gram-positive bacteria(27.9%)and gram-negative bacteria(72.1%).The prevalence of methicillin-resistant strains was 20.0%in S.aureus(MRSA),and 72.2%in coagulase-negative Staphylococcus(MRCNS).Methicillin-resistant staphylococcal strains were more resistant to most antimicrobial agents than methicillin-susceptible strains(MSSA and MSCNS).None of the staphylococcal strains was resistant to vancomycin,linezolid or tigecycline.Enterococcus faecium strains showed higher resistance rates to most antimicrobial agents than Enterococcus faecalis.None of enterococcal strains was resistant to vancomycin.A few enterococcal strains were resistant to linezolid.Overall,691 strains of the non-meningitis Streptococcus pneumoniae were isolated from children and 123 strains were isolated from adults.The prevalence of penicillin-resistant S.pneumoniae(PRSP)was 0.4%in the strains from children and 1.6%in the strains from adults.None of S.pneumoniae strains was intermediate to penicillin.The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn)was 1.2%,1.2%,and 13.8%in 2020,2021,and 2022,respectively.The prevalence of carbapenem-resistant P.aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 10.7%and 68.4%in 2020,17.5%and 75.2%in 2021,14.3%and 77.3%in 2022,respectively.About 84.6%of the 1269 strains of Haemophilus influenzae were isolated from children and 15.4%isolated from adults.The prevalence of beta-lactamase-producing strains was 3

关 键 词：耐药监测 药敏试验 全自动微生物质谱检测仪 碳青霉烯类耐药菌 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]