内蒙古医科大学附属医院2018年细菌耐药监测

Antimicrobial resistance profile of clinical isolates in Inner Mongolia Medical University Affiliated Hospital in 2018

目的了解我院临床常见分离菌对常用抗菌药物的耐药性和敏感性。方法对我院临床分离菌采用纸片扩散法或自动化仪器法进行抗菌药物敏感性试验。按美国临床实验室标准化研究协会(CLSI)2017版判断结果。结果2018年我院临床分离细菌共6573株,革兰阴性菌4701株(71.5%),革兰阳性菌1872株(28.5%)。主要来源于痰、伤口脓液、血液和尿液标本。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分离率分别为20.9%和72.7%。MRSA对绝大多数测试药的耐药率均显著高于甲氧西林敏感金黄色葡萄球菌(MSSA),未发现万古霉素和利奈唑胺耐药菌株。肠球菌属中粪肠球菌对所有抗菌药的耐药率均显著低于屎肠球菌,粪肠球菌和屎肠球菌中未出现对利奈唑胺耐药的菌株,屎肠球菌发现对万古霉素耐药株。肺炎链球菌非脑膜炎株对青霉素的耐药率9.1%。肠杆菌科细菌对碳青霉烯类仍高度敏感,CRE分离率2.6%,较上一年度(2.4%)略有上升。鲍曼不动杆菌耐药仍然较为严重,对亚胺培南和美罗培南的耐药率分别为48.7%和50.8%。铜绿假单胞菌对亚胺培南和美罗培南耐药率分别为19.7%和12.3%,耐碳青霉烯类抗菌药物铜绿假单胞菌(CRPE)和鲍曼不动杆菌(CRAB)检出率分别为22.0%和50.1%。结论临床分离菌对常用抗菌药物的耐药仍然呈现多重耐药,近年CRE的分离率呈上升趋势。应加强医院感染防控措施和抗菌药物临床应用管理措施,做好细菌耐药性监测工作。

Objective To investigate the resistance and sensitivity of common clinical isolates in our hospital to commonly used antibiotics.Methods The antibacterial susceptibility test was carried out on the clinical isolates of our hospital using the Kirby-Bauer method or the automated instrument method.Results were interpreted according to the breakpoints of CLSI 2017.Results A total of 6,573 clinically isolated bacteria were collected in our hospital from January to December 2018.4,701(71.5%)were Gram-negative bacteria,and 1,872(28.5%)were Gram-positive bacteria mainly from sputum,wound pus,blood,and urine specimens samples.The isolation rates of methicillinresistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative staphylococci(MRCNS)were 20.9%and 72.7%,respectively.The resistance rates of MRSA to most test drugs were significantly higher than that of methicillin-sensitive Staphylococcus aureus(MSSA).No vancomycin and linezolid resistant strains were found.The resistance rates of Enterococcus faecalis to all antimicrobial agents were significantly lower than those of Enterococcus faecium.No strains resistant to linezolid were found in Enterococcus faecalis and Enterococcus faecium.Vancomycin-resistant strains were found in Enterococcus faecium.The resistance rate of Streptococcus mutans nonmeningitis strain to penicillin was 9.1%.Enterobacteriaceae bacteria were still highly sensitive to carbapenems,with a CRE separation rate of 2.6%,a slight increase from the previous year(2.4%).The resistance of Acinetobacter baumannii was still serious,and the resistance rates to imipenem and meropenem were 48.7%and 50.8%,respectively.The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 19.7%and 12.3%,and the detection rates of carbapenem-resistant Pseudomonas aeruginosa(CRPE)and Acinetobacter baumannii(CRAB)were 22.0%and 50.1%.Conclusions The resistance of clinical isolates to commonly used antibiotics was still multi-drug resistant.In recent years,the separation rate of CRE has risen slightly.It is necessary to strengthen the prevention and control measures for hospital infections and clinical application management measures for antibacterial drugs,and do a good job in monitoring bacterial resistance.