2015年齐齐哈尔市第一医院细菌耐药性监测

Surveillance of antibiotic resistance in the bacterial strains isolated from the First Hospital of Qiqihar in 2015

目的了解齐齐哈尔市第一医院临床分离菌的分布及耐药性,为临床合理使用抗菌药物提供依据。方法采用自动化仪器对2015年1月1日-12月31日该院临床分离菌进行药敏试验,采用CLSI 2014年版标准判断药敏结果及WHONET 5.6软件进行数据分析。结果 2015年1月1日-12月31日收集临床分离菌5 162株,其中革兰阳性菌1 450株,占28.1%,革兰阴性菌3 712株,占71.9%。葡萄球菌属中甲氧西林耐药金黄色葡萄球菌和凝固酶阴性葡萄球菌的检出率分别为36.5%(255/698)和81.4%(180/221),未发现对万古霉素和利奈唑胺耐药的金黄色葡萄球菌。肠球菌属对万古霉素和利奈唑胺耐药率较低,其中检出1株对万古霉素耐药的屎肠球菌。大肠埃希菌、克雷伯菌属细菌和奇异变形杆菌产超广谱β内酰胺酶(ESBL)株平均检出率分别为39.9%(298/747)、26.1%(294/1 127)和15.6%(12/77),肠杆菌科细菌对碳青霉烯类、含β内酰胺酶抑制剂的复合制剂、阿米卡星耐药率相对较低。泛耐药鲍曼不动杆菌与泛耐药铜绿假单胞菌的检出率分别为36.6%(163/445)和1.8%(13/715)。结论细菌耐药性仍对临床构成严重威胁,应引起高度重视,临床微生物室应继续加强细菌耐药性监测,为临床提供更好的数据支持。

Objective To investigate the distribution and antibiotic resistance profile of clinical isolates in the First Hospital of Qiqihar during 2015. Methods Antimicrobial susceptibility test was carried out according to a unified protocol using automated system from January 1, 2015 to December 31,2015. The results were analyzed with WHONET 5.6 software according to the 2014 breakpoints of Clinical and Laboratory Standards Institute. Results A total of 5 162 clinical isolates were collected, of which 28.1% （1 450/5 162） were gram-positive cocci and 71.9% （3 712/5 162） were gram-negative bacilli. About 36.5% （255/698） ofS. aureus isolates and 81.4% （ 180/221 ） ofcoagulase negative Staphylococcus isolates were resistant to methicillin. No S. aureus and coagulase negative Staphylococcus isolate were found resistant to vancomycin or linezolid. Enterococcus isolates showed low resistance to vancomycin and linezolid. One strain of E. faecium was found resistant to vancomycin. ESBLs were produced in 39.9% （298/747） of E. coli, 26.1% （294/1 127） of Klebsiella spp., and 15.6% （12/77） of P. mirabilis strains. The Enterobacteriaceae strains were less resistant to imipenem, beta-lactam/beta-lactamase inhibitor combination and amikacin. About 36.6% （163/445） of A. baumannii isolates and 1.8% （13/715） of P. aeruginosa isolates were extensively drug-resistant strains. Conclusions Antibiotic resistance poses a serious threat to clinical practice, to which more attention should be paid. Clinical microbiology lab should make more efforts to provide better support to clinical therapy.