某医院2014年临床细菌耐药性监测情况及耐药分析

Monitoring on clinical bacterial resistance in a hospital in 2014 and analysis on drug resistance

目的观察并分析内蒙古包头包头市第四医院2014年临床送检标本中的病原菌对常用抗菌药物的耐药情况。方法收集该院2014年1-12月临床送检标本中分离的病原菌株及药敏试验数据。采用VITEK、ATB或手工方法进行目标细菌鉴定,采用K-B法、MIC法进行药敏试验。结果该院临床分离出病原菌共3 134株,其中革兰阳性菌780株(占24.9%),革兰阴性菌2 354株(占75.1%)。凝固酶阴性葡萄球菌和金黄色葡萄球菌的耐甲氧西林检出率分别为80.9%和20.2%,葡萄球菌属中均未检出对万古霉素、替考拉宁和利奈唑胺耐药的菌株。大肠埃希菌和肺炎克雷伯菌的超广谱β-内酰胺酶产生率分别是61.2%和37.9%。革兰阴性菌整体上对亚胺培南敏感。结论该院2014年临床送检标本中分离病原菌的耐药现象比较严重,进一步开展细菌耐药监测工作,对促进临床合理使用抗菌药物具有重要意义。

Objective To observe and analyze the drug resistance of pathogenic bacteria in clinical samples in the Fourth Hospital of Baotou in 2014 to commonly used antibiotics. Methods The pathogenic bacteria isolated from clinical samples in the hospital in 2014 as well as the drug sensitive test data were collected. VITEK,ATB or manual methods were used to conduct target bacteria identification,and drug sensitive test was conducted with K-B method and MIC method. The data was analyzed by WHONET 5.6 software according to the standards of CLSI in 2014. Results A total of 3134 strains of pathogenic bacteria were isolated from clinical samples,of which 780（24.9%） strains were Gram-positive bacteria and 2 354（75.1%） strains were Gram-negative bacteria. The detection rate of methicillin-resistance of coagulase negative staphylococcus and staphylococcus aureus was 80.9% and 20.2%,respectively. But no strains of staphylococcus were detected to be resistant to vancomycin,teicoplanin or linezolid. The detective rate of extended-spectrum-beta-lactamase（ESBL） in escherichia coli and klebsiella pneumonia was 61.2% and 31.9%,respectively. Gram-negative bacteria were sensitive to imipenem as a whole. Conclusion The drug resistance of the pathogenic bacteria isolated from clinical samples in the hospital in 2014 was very serious. Further conducting bacterial resistance is of great importance to promoting clinical reasonable use of antibiotics.