2014年度渝东北部分片区细菌耐药性监测报告

2014 annual report of bacterial drug resistance surveillance in northeast of Chongqing

目的：分析该院2014年主要病原菌分布与耐药性，利于多重耐药菌监测及临床抗菌药物的合理使用。方法回顾性分析2014年送检标本中分离病原菌分布及耐药性，利用WHONET 5．6软件进行数据分析。结果送检的8368例标本中分离病原菌3013株，其中革兰阴性杆菌2363株（78．43％），革兰阳性球菌650株（21．57％）。排前5位革兰阴性杆菌分别是大肠埃希菌（663株）、肺炎克雷伯菌（490株）、流感嗜血杆菌（368株）、鲍曼不动杆菌（177株）、铜绿假单胞菌（170株）。革兰阳性菌以金黄色葡萄球菌为主，共334株，占革兰阳性球菌51．38％，其中耐甲氧西林金黄色葡萄球菌143株，甲氧西林敏感金黄色葡萄球菌191株。肠杆菌科细菌对碳青霉烯类药物敏感性最高。流感嗜血杆菌对环丙沙星和第2代头孢类抗菌药物敏感性较好。铜绿假单胞菌对阿米卡星、庆大霉素、妥布霉素、哌拉西林／他唑巴坦等耐药率较低，约2．00％～5．00％。多重耐药菌占病原菌16．99％，以泛耐药鲍曼不动杆菌为主。结论该院病原菌以革兰阴性杆菌为主，多重耐药菌比例较高，应加强对抗菌药物使用管理，合理使用抗菌药物，防止细菌产生耐药性。

Objective To analyze the distribution and drug resistance of pathogenic bacteria in the hospital during 2014 ,which was conducive to the rational use of clinical antibacterial drugs .Methods The data of bacterial strains isolated from specimens in hospitalized patients during 2014 were collected and statistically analyzed by the software of WHONET 5 .6 .Results In 8 368 detected specimens ,3 013 strains of pathogenic bacteria were detected , including 2 363 strains of gram‐negative bacteria ,accounting for 78 .43% ,650 strains of gram‐positive bacteria ,ac‐counting for 21 .57% .The top five pathogens were E .Coli（663） ,K .Pneumonia（490） ,H .Influ（368） ,A .Baumanii （177） and P .Aeruginosa（170） .The sensitive rate of Enterobaeteriaceae remained high to carbapenem .Drug resistance to amikacin ,gentamicin ,tobramycin ,piperacillin/tazobactam of P .Aeruginosa was relatively low ,it was about 2 .00% to 5 .00% .Multi‐drug resistant bacteria accounted for 16 .99% ,especially Acinetobacter Bauman .Conclusion The main path‐ogenic bacteria in the hospital is gram‐negative bacteria ,and the proportion of multi drug resistant bacteria is high . Doctors should strengthen the management of the use of antimicrobial agents ,rational use of antibiotics ,and prevent the bacteria from producing drug resistance .