北京平谷地区2011～2013年细菌耐药趋势观察

Bacterial drug resistance trend observation of Pinggu area from 2011 to 2013

目的调查平谷地区2011-2013年临床分离病原菌的耐药情况,指导临床合理使用抗菌药物。方法收集该院2011-2013年临床分离病原菌,将所有分离的病原菌全部鉴定到种并进行药敏试验,同一患者、同一部位的感染菌只选取首次分离株,数据审核后录入WHONET5.6软件,数据分析依据美国临床实验室标准化协会文件M100-S22标准。结果 2011-2013年临床分离病原菌共5 794株。2011年1 600株、2012年2 234株、2013年1 960株。耐甲氧西林金黄色葡萄球菌（MRSA）检出率各年度分别为63.50%、65.00%、65.30%,未发现对万古霉素和利奈唑胺耐药的葡萄球菌。肠球菌耐药率：替考拉宁小于5%,利奈唑胺小于2.4%,万古霉素小于21.1%。大肠埃希菌、肺炎克雷伯菌对亚胺培南、美罗培南耐药率均小于1.3%。各年度鲍曼不动杆菌对亚胺培南耐药率分别为34.6%、26.9%、29.3%。铜绿假单胞菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药率低于全国平均水平,未发现对多黏菌素B耐药的菌株。嗜麦芽窄食单胞菌对头孢他啶和米诺环素全部敏感。结论平谷地区细菌耐药性数据存在地区特异性,与2011年度全国细菌耐药监测报告的数据存在差异。MRSA检出率,肠球菌对利奈唑胺和万古霉素的耐药率,大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌对亚胺培南、美罗培南的耐药率呈逐年上升趋势。鲍曼不动杆菌、铜绿假单胞菌耐药率低于全国平均水平。

Objective To investigate the drug resistance of clinical isolates in Pinggu area from 2011 to 2013,and guide clinical rational use of antibiotics. Methods Isolates from 2011 to 2013 in the hospital were collected and identified to species. Antibiotic susceptibility test were performed. For the infection with the same position and the same patient,only the first isolate was included. WHONETS. 6 data analysis software was used for data auditing and inputing,the USA CLSI M100-S22 standard were refered to. Results Total of 5 794 strains of clinically isolated pathogenic bacteria were collected from 2011 to 2013,1 600 strains in 2011, 2 234 strains in 2012,1 960 strains In 2013. The detection rate of MRSA in each year from 2011 to 2013 were 63.50% ,65. 00%, 65.30% respectively. No vancomycin and linezolid-resistant Staphylococcus aureus was found. The resistance rate of Enterococcus to teicoplanin was 〈5 % ,to Linezolid 〈2.4 % and to vancomycin 〈21.1 %. The resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem and meropenem were both 〈 1.3 %. The annual resistance rates of Acinetobacter bauman to imipenem were 34.6 %, 26.9 %, 29.3 % respectively. Resistance rates of Pseudomonas aeruginosa to imipenem, meropenem, cefoperazone/shu batan,piperacillin/tazobactam were lower than the national average. No polymyxin B resistance isolate was found. Stenotrophomonas maltophilia were sensitive to ceftazidime and minocycline. Conclusion The antibiotic resistance rate data in Pinggu exhibits area specificity, which was different from the national antimicrobial resistance monitoring data in 2011. Detection rate of MRSA, resistance rate of enterococci to linezolid and vancomycin,Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae to imipenem, meropenem are increasing year by year. The resistance rates of Acinetobacter bauman and Pseudomonas aeruginosa are lower than the national average rate.