某三甲医院细菌耐药监测分析

Analysis on antimicrobial resistance surveillance in a Class A tertiary hospital

目的分析安徽医科大学第一附属医院细菌耐药性监测的情况,控制多重耐药菌院内感染流行暴发,保障抗菌药物临床有效治疗。方法收集2020年1—12月微生物检验科接收感染类患者的血液、尿液、粪便、呼吸道分泌液等标本进行微生物检验和细菌耐药性监测工作。结果共计分离出11651株致病菌株,其中革兰氏阳性菌和革兰氏阴性菌分别占27.8%和72.2%。分离率占前三位的是大肠埃希菌占21.1%,肺炎克雷伯菌占14.2%,金黄色葡萄球菌占9.9%,碳氢酶烯耐药铜绿假单胞菌基本与CHINET水平一致;鲍曼不动杆菌细菌耐药率高于CHINET水平。结论该院细菌耐药形势较严峻,须根据细菌耐药监测结果指导临床合理使用抗菌药物,同时应结合医院感染预防控制措施,才能有效控制耐药细菌的流行播散。

Objective To analyze the situation of antimicrobial resistance surveillance in the First Affiliated Hospital of Anhui Medical University,in order to control the epidemic outbreak of nosocomial infections with multi-antibiotic resistant bacteria and ensure effective clinical treatment with antimicrobial drugs.Methods Blood,urine,stool and respiratory secretion specimens from infected patients admitted to the Microbiology Laboratory from January to December 2020 were collected for microbiological testing and antimicrobial resistance surveillance.Results A total of 11651 pathogenic strains were isolated,of which Gram-positive and Gramnegative bacteria accounted for 27.8%and 72.2%,respectively.The three pathogenic strains with the highest isolation rate were Escherichia coli(21.1%),Klebsiella pneumoniae(14.2%)and Staphylococcus aureus(9.9%).The level of hydrocarbon resistant Pseudomonas aeruginosa is basically consistent with that of CHINET;The resistance rate of Acinetobacter baumannii was higher than that of CHINET.Conclusion This hospital is facing serious antimicrobial resistance.To effectively control the epidemic spread of antibiotic-resistant bacteria,the clinical use of antimicrobial drugs must be guided according to the results of antimicrobial resistance surveillance,and hospital infection prevention and control measures should be taken at th e same time.