2011—2012年我院临床病原菌分布及耐药性分析

Distribution and antibiotic resistance of clinical pathogenic bacteria causing nosocomial infection from 2011 to 2012

目的分析新疆地区2011—2012年临床细菌分布及耐药性,为临床合理使用抗生素提供参考依据。方法回顾性分析2011—2012年临床病原菌分布及耐药情况,采用WHONET5.6软件统计分析。结果 2011—2012年共分离8999株病原菌,革兰阴性杆菌72.5%,革兰阳性球菌27.5%。肠杆菌科常见的大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌对碳青霉烯类、头孢哌酮/舒巴坦、哌拉西林/三唑巴坦耐药率低,其中2年来产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌检出率为31.6%、53.9%和31.4%、33.6%;非发酵菌中铜绿假单胞菌对哌拉西林/三唑巴坦、妥布霉素耐药率低,鲍曼不动杆菌对大多数抗生素耐药率偏高,泛耐药株(PDR)2年检出率为2.1%、5.5%;未发现耐利奈唑胺、万古霉素、替考拉宁的葡萄球菌属和肠球菌属,MRSA和MRSCN两年的检出率分别为51.5%、42.6%和79.6%、86.3%。结论监测结果对临床正确合理使用抗生素,降低细菌耐药有积极意义。

Objective To investigate the antimicrobial resistance and microbial distribution in Xinjiang from 2011 to 2012, and to provide reference for rational use of antibiotic in clinical practice. Methods All pathogenic distribution and resistance were analyzed statistically by retrospective study and WHONET 5.6. Results Among 8999 strains from 2011 to 2012, Gram-negative bacteria and Gram-positive bacteria accounted for 72.5% and 27.5%. The most common sites of Enterobacteriaceae bacteria were Escherichia coli, Klebsiellapneumoniae and Enterobacter cloacae which had the low resistance rates to carbapenems, cefperazone-sulbactam and piperacillin-tazobactam. The resistance rates to imipenem of ESBLs-producing E. coli and K. pneumoniae in two years were 31.6%, 53.9% and 31.4%, 33.6%, respectively. The Pseudomonas aeruginosa of nonfermenting bacteria had low resistance rates to piperacillin-tazobactam and tobramycin. The resistance rates to most antibiotic of Acinetobacter baumannii were higher and PDR were 2.4% and 5.3% in two years. No strains of linezolid-resistant, vancomycin-resistant and teicoplanin-resistant Staphylococci and Enterococcus were found. The detection rates of MRSA and MRSCN were respectively 51.5%, 42.6% and 79.6%, 86.3% in two years. Conclusion The monitoring result can provide the guidance for clinical use of antimicrobial agents in order to reduce the occurrence of bacteria drug-resistance.