目的 分析医院分离主要菌株的分布特点与耐药情况,为临床合理使用抗菌药物提供参考依据。方法 收集2018年临床分离的常见可致病菌株5 916株,使用VITEK-2 Compact系统进行细菌鉴定,采用MIC法和K-B纸片扩散法进行药敏试验,采用WHONET 5.6软件对数据进行统计分析。结果 5 916株菌株标本主要来源于尿液、痰液、分泌物和血液。其中,革兰阴性菌占66.9%,主要为大肠埃希菌;革兰阳性菌占20.4%,主要为金黄色葡萄球菌。革兰阴性菌如大肠埃希菌、肺炎克雷伯菌对氨苄西林耐药率最高(分别为82.8%和71.2%),对碳青霉烯类药物的耐药率分别为1.9%、16.5%。革兰阳性菌如金黄色葡萄球菌、表皮葡萄球菌对青霉素G的耐药率最高(分别为92.2%和93.9%),对利奈唑胺、万古霉素、替加环素的耐药率均为0%。鲍曼不动杆菌对亚胺培南、美洛培南的耐药率分别为53.5%、50.3%。铜绿假单胞菌对亚胺培南、美洛培南的耐药率分别为13.2%、8.7%。结论 2018年某医院临床耐药菌株种类较多,医务人员应严格落实感控措施,合理使用抗菌药物。
Abstract
Objective To analyze the distribution characteristics and the antimicrobial resistance of main isolates in a hospital,so as to provide the reference for reasonable use of antibacterial drugs in clinical departments. Methods A total of 5916 strains of common pathogenic bacteria were collected from clinical isolates in 2018.VITEK-2 compact system was used for bacterial identification,Mic method and K-B disk diffusion method were used for drug sensitivity test.WHONET 5.6 software was used for statistical analysis of the data. Results The specimens of 5916 strains were main originated from urine,sputum,secretions,and blood.The Gram-negative bacteria accounted for 66.9%,which mainly includes Escherichia coli.The Gram-positive bacteria accounted for 20.4%,which mainly includes Staphylococcus aureus.The Gram-negative bacteria such as Escherichia coli and Klebsiella pneumoniae have the highest resistance rates to ampicillin (82.8% and 71.2% respectively),and their resistance rates to carbapenems are 1.9% and 16.5% respectively.The Gram-positive bacteria such as Staphylococcus aureus and Staphylococcus epidermidis have the highest resistance rates to penicillin G (92.2% and 93.9% respectively),and their resistance rates to linezolid,vancomycin,and tigecycline are 0%.The resistance rates of Acinetobacter baumannii to imipenem and meropenem were 53.5% and 50.3% respectively.The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 13.2% and 8.7% respectively. Conclusions There are many types of drug-resistant strains isolated from clinical in a hospital in 2018.Medical staffs should strictly implement the control measures of infection,and reasonably use antibacterial drugs.
关键词
病原菌 /
耐药性监测 /
抗菌药物
Key words
Pathogen /
Drug-resistant surveillance /
Antibacterial drugs
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参考文献
[1] 彭燕琼.2016-2017年某院细菌耐药检测分析[J].海峡药学,2018,30(08):273-275.
[2] 黄翠珠,覃琼英,车汉荣,等.院内病原菌的分布、构成及耐药监测[J].世界最新医学信息文摘,2019,19(37):33-35.
[3] Clinical And Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing[M].Wayne: CLSI.2016:M100S-S26E.
[4] 尚红,王毓三,申子瑜.全国临床检验操作规程[M].4版.北京:人民出版社,2014.
[5] 李春辉,吴安华.医疗机构耐药菌MDR、XDR、PDR的国际标准化定义专家建议(草案)[J].中国感染控制杂志,2011,10(3):238-240.
[6] 黄勋,邓子德,倪语星,等.多重耐药菌医院感染预防与控制中国专家共识[J].中国感染控制杂志,2015,14(1):1-9.
[7] 胡付品,郭燕,朱德妹,等.2017年CHINET中国细菌耐药性监测[J].中国感染与化疗杂志,2018,18(3):241-251.
[8] 陈熔,王旭,钟册俊,等.金黄色葡萄球菌血流感染112例临床特征及预后分析[J].中国感染与化疗杂志,2019,19(3):233-236.
[9] Van Hal S J,Jensen SO,Vaska VL,et al.Predictors of mortality in Staphylococcus aureus bacteremi[J].Clin Microbiol Rev,2012,25(2):362-386.
[10] 李玲,夏玲华.2018年1~6月我院细菌耐药监测数据分析[J].世界最新医学信息文摘,2018,18(A4):147-150.
[11] 王辉,宁永忠,陈宏斌,等.常见细菌药物敏感性试验报告规范中国专家共识[J].中华检验医学杂志,2016,39(1):18-22.
[12] 李平,金炎,邵春红,等.住院患者感染病原菌和常用抗菌药物敏感性分析[J].检验医学与临床,2015,12(6):838-841.
[13] Tian L,Zhang Z,Sun Z.Antimicrobial resistance trends in bloodstream infections at a large teaching hospital in China: a 20-year surveillance study (1998-2017)[J].Antimicrobial resistance and infection control,2019,8.
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