2014年住院患者临床分离细菌的耐药性研究

Drug resistance of clinical isolates from hospitalized patients in 2014

目的了解并分析河北医科大学第二医院2014年住院患者临床分离菌对抗菌药物的耐药性,为进一步提高医院抗感染诊疗水平提供参考。方法收集2014年1-12月共6 365株非重复细菌,采用法国生物梅里埃公司VITEK-2Compact全自动细菌鉴定药敏仪进行细菌鉴定和药敏试验检测,使用Whonet5.6软件对数据进行统计分析。结果共分离病原菌6 365株,其中革兰阴性菌4 775株占75.0%,以大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌为主,革兰阳性菌1 590株占25.0%,以葡萄球菌属和肠球菌属为主,耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林人葡萄球菌(MRSHO)、耐甲氧西林表皮葡萄球菌(MRSE)、耐甲氧西林溶血葡萄球菌(MRSHL)的检出率分别为61.7%、83.5%、83.7%、95.8%;葡萄球菌属未发现对万古霉素、替考拉宁和利奈唑胺耐药的菌株;大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的耐药率均<20.0%,头孢菌素中头孢吡肟表现了较好的敏感性。结论细菌对抗菌药物的耐药性在不断变化,需采取有效的医院感染预防控制措施,进一步规范控制抗菌药物使用。

OBJECTIVE To understand the drug resistance of clinical strains that were isolated from the patients who were hospitalized the Second Hospital of Hebei Medical University in 2014 so as to improve the diagnosis and treatment of infections.METHODS A total of 6 365 strains of non-repetitive bacteria were collected from Jan 2014 to Dec 2014,then the bacterial identification was carried out by using VITEK-2Compact automatic bacterial identification system,the drug susceptibility testing was conducted by means of drug susceptibility system,and the statistical analysis of data was performed with the use of Whonet5.6software.RESULTS Totally 6 365 strains of pathogens were isolated,including 4 775（75.0%）strains of gram-negative bacteria and 1 590（25.0%）strains of gram-positive bacteria;the Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,and Pseudomonas aeruginosa were dominant among the gram-negative bacteria;the Staphylococcus spp and Enterococcus spp were the predominant gram-positive bacteria.The isolation rates of the methicillin-resistant Staphylococcus aureus（MRSA）, methicillin-resistant Staphylococcus hominis, methicillin-resistant Staphylococcus epidermidis（MRSE）,and methicillin-resistant Staphylococcus haemolyticus（MRSHL）were 61.7%,83.5%,83.7%,and95.8%,respectively.The Staphylococcus spp strains were not found to be resistant to vancomycin,teicoplanin,or linezolid.The drug resistance rates of the E.coli,K.pneumoniae,and Enterobacter cloacae to cefoperazonesulbactam and piperacillin-tazobactam were less than 20.0%;among the cephalosporins,the strains were highly susceptible to cefepime.CONCLUSIONThe drug resistances of the strains are constantly changed,and it is necessary to take effective prevention measures and further standardize the use of antibiotics.