摘要
目的:监测评价2013—2014年南阳市市区五家三级综合医院检出菌分布和耐药情况。方法:收集五家医院临床分离菌信息,对细菌培养阳性率、常见分离菌种类、细菌药敏结果等进行统计分析。结果:五家医院两年共送检标本102318例,其中检出28755例,检出阳性率为28.10%。分离的28755株细菌中革兰阳性菌5755株(占20.01%),革兰阴性菌20689株(占71.95%),真菌2311株(占8.04%)。主要检出菌为大肠埃希菌(占14.82%)、肺炎克雷伯菌(占13.75%)、铜绿假单胞菌(占12.41%)、鲍曼不动杆菌(占10.01%)、凝固酶阴性葡萄球菌(占8.04%)、金黄色葡萄球菌(占5.16%)等。MRSA及MRC—NS的检出率分别为56.81%和76.95%,大肠杆菌属和肺炎克雷伯菌属产超广谱p内酰胺酶菌的检出率分别为59.99%和38.71%,未检出对万古霉素耐药的葡萄球菌。葡萄球菌对青霉素、头孢呋辛、红霉素耐药率在80%以上,对庆大霉素、呋喃妥因较敏感,耐药率在4.68%~31.32%之间。大肠埃希菌和肺炎克雷伯菌对氨苄西林、头孢唑林、头孢呋辛、头孢曲松耐药率在63.87%~93.03%之间,对亚胺培南、美罗培南、呋喃妥因、阿米卡星、哌拉西林他唑巴坦和头孢哌酮舒巴坦较敏感,耐药率为0.92%~27.22oA。铜绿假单胞菌对阿米卡星、庆大霉素耐药率较高,分别为57.19%和64.19%,对黏菌素、亚胺培南、美罗培南、头孢吡肟、哌拉西林他唑巴坦和头孢哌酮舒巴坦较敏感,耐药率为1.65%~27.33%。鲍曼不动杆菌对头孢哌酮舒巴坦及复方磺胺甲-恶唑的耐药率相对较低,分别为37.69%和44.04%,对其他临床常见抗菌药物的耐药率均大于60%。结论:鉴于南阳市市区五家三级综合医院的细菌耐药情况,医院须加强细菌耐药监测和感染控制。
OBJECTIVE To monitor and assess antimicrobial resistance of bacteria in 5 hospitals of Nanyang city from 2013 to 2014. METHODS Cultivated bacteria were collected form 5 hospitals, positive rate, common bacterial species and results of drug sensitive test were summarized. RESULTS A total of 28755 bacteria were collected form 102318 specimens. The positive rate was 28. 10%, gram-negative bacilli, gram-positive bacilli and fungi accounted for 71.95%, 20. 01% and 8. 04%, respectively. The most common isolates were escherichia coli(14. 82%), klebsiella pneumoniae (13. 75%), pseudomonas aeruginosa (12. 41%), bauman acinetobacter (10. 01%), coagulase negative staphylococcus (8. 04%), staphylococcus aureus (5.16%). The detection rate of methicillin-resistant isolates were 56. 81% and 76. 95% in S. aureus (MRSA) and coagulase negative Staphylococcus (MRCNS). Detection rates of escherichia coli and klebsiella pneumoniae procing ESBLs were 59. 99% and 38.71%, respectively. No vancomycin resistant isolate was found in staphylococcus. Resistance rates of staphylococcus strains to penicillin, cefuroxime and erythromycin were all higher than 80%, and it was sensitive to gentamicin and nitrofurantoin, the resistance rates were from 4. 68% to 31.32%. Resistance rates of escherichia coli and klebsiella pneumonia to ampicillin, cefazolin, cefuroxime and ceftriaxone were 63.87% to 93.03%, and it was sensitive to imipenem, meropenem, nitrofurantoin, amikacin, piperacillin and tazobactam and cefoperazone and sulbactam, and the resistance rates were 0. 92% to 27. 22%. Resistance rates of pseudomonas aeruginosa to amikacin and gentamicin were 57. 19% and 64. 19%, and it was sensitive to Coilstin, imipenem, meropenem, cefepime, piperacillin and tazobactam and cefoperazone and sulbactam, the resistance rates were 1.65% to 27. 33%. Resistance rates of acinetobacter baumannii to cefoperazone and sulbactam and sulfamethoxazole were 37. 69% and 44. 04%, the resistance rates of acinetobacter baumannii to other common antibacterials were higher than 60%. CONCLUSION Bacterial resistances in urban area of Nanyang city were high. Hospital management should strengthen surveillance of bacterial resistance and infection control.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2015年第19期1783-1787,共5页
Chinese Journal of Hospital Pharmacy
关键词
耐药菌
抗菌药物
监测
bacterial drug-resistance
antibaeterials
monitor