2018年武警某医院细菌耐药性监测

Surveillance of antibiotic resistance in some medical center of PAP in 2018

【目的】了解2018年武警特色医学中心常见临床分离菌耐药性,为抗菌药物合理使用和临床抗感染治疗提供参考。【方法】收集2018年临床分离的8015株非重复细菌,采用自动化仪器法或纸片扩散法进行药敏试验,按照2017年临床和实验室标准化协会标准判读结果。【结果】8015株非重复细菌中,革兰阴性菌占77.6%,革兰阳性菌占22.4%。前5位分离菌是肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌、金黄色葡萄球菌,所占比例分别为18.8%、16.9%、16.0%、9.8%、8.8%。耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌的检出率分别占各自菌种的53.9%和62.7%。肠杆菌科细菌对碳青霉烯类保持较高敏感,碳青霉烯类耐药的肺炎克雷伯菌和大肠埃希菌各占分离菌种的23.0%和8.5%。鲍曼不动杆菌和铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为85.1%和81.7%、47.7%和38.1%。【结论】临床分离菌株对不同抗菌药物呈现不同耐药率,应加强实验室与临床的沟通,合理使用抗菌药物,避免耐药菌株的广泛传播。

【Objective】To learn the antimicrobial resistance of common clinical bacterial isolates in Characteristic Medical Center of PAP in 2018 for rational antimicrobial therapy and control of infections.【Methods】A total of 8015 non-duplicate clinical isolates were collected in 2018.Antimicrobial susceptibility test was carried out according to the automated system or Kirby-Bauer method.The results were analyzed according to CLSI 2017 standards.【Results】Gram-negative bacillin and gram-positive cocci respectively accounted for 77.6%and 22.4%among 8015 clinical isolates.The top five bacterial species were Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coil,Acinetobacter baumannii and Staphylococcus aureus,accounting for 18.8%,16.9%,16.0%,9.8%and8.8%,respectively.Methicillin-resistant stains in S.aureus(MRSA)and coagulase-negative Staphylococcus(MRCNS)accounted for53.9%and 62.7%,respectively.Enterbacteriaceae strains were still highly susceptible to carbapenems.The prevalence of carbapenemresistant strains was 23.0%in Klebsiella pneumoniae and 8.5%in E.coil,respectively.The percentage of Acinetobacter baumannii and Pseudomonas aeruginosa resistant to imipenem and meropenem were 85.1%and 81.7%,47.7%and 38.1%,respectively.【Conclusion】The clinical bacterial isolates show various levels of resistance to antimicrobial agents.Laboratory staff should improve communication with clinicians for rational use of antimicrobial agents to prevent the spread of resistant strains.