2015年临床分离菌株分布及耐药性分析

Analysis of the distribution and drug-resistance clinical isolates in 2015

目的了解本院临床分离菌株的分布及耐药性。方法采用抗菌药物MIC和纸片扩散法药敏试验。参照CLSI2014年版标准判读药敏结果,用WHONET 5.6软件进行总结分析。结果 2014年11月-2015年11月共收集非重复临床分离菌株4 998株,革兰阴性菌3 378株,占67.6%;革兰阳性菌1 620株,占32.4%。居前5位的细菌依次为大肠埃希菌(22.3%)、肺炎克雷伯菌(13.2%)、鲍曼不动杆菌(9.5%)、铜绿假单胞菌(7.2%)、金黄色葡萄球菌(7.1%)。肠杆菌科细菌、铜绿假单胞菌、鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别为<3%、<20%、<50%。耐甲氧西林金黄色葡萄球菌的检出率为12.4%,耐甲氧西林凝固酶阴性葡萄球菌占81.1%,未检出耐万古霉素和耐利奈唑胺的菌株。检出耐万古霉素粪肠球菌1株,屎肠球菌3株。结论山西大医院临床分离菌株以革兰阴性杆菌为主,与全国耐药监测数据相符,耐药情况不容忽视。

Objective To investigate the distribution and drug - resistance of clinical isolates in our hospital. Methods The antimicrobial drug MIC and paper diffusion method were used to conduct the drug sensitivity test. Drug sensitivity results were interpreted referring to CLSI 2014 version and analyzed by WHONET 5.6 software. Results From November 2014 to Novem- ber 2015, a total of 4 998 strains of non repetitive clinical isolates were collected, in which there are 3 378 gram - negative strains, accounting for 67.6% , and 1 620 gram - positive strains, accounting for 32.4%. The top five are E. coli bacteria （22.3%）, KlebsieUa pneumoniae （13.2%）, acinetobacter baumannii （9.5%）, P. aeruginosa（ 7.2% ）, Staphylococcus aureus （7.1% ）. The resistant rate of Enterobacteriaceae, Pseudomonas aeruginosa Acinetobacter baumannii strains to imipenem and meropenem was less than 3%, 〈 20% , 〈 50% , respectively. The proportion of resistant to the Staphylococcus aureus was 12.4% and the proportion of methicillin -resistant coagulase negative staphylococcus was 81.1%. Strains resistant to vancomy- cin and linezolid were not detected out. 1 strain enterococcus faecalis resistant to vancomycin and 3 strains enterococcus faecium were detected out. Conclusion The clinical isolates in Shanxi Dayi hospital are mainly gram - negative bacilli, consistent with the national drug resistance monitoring data, and drug resistance can not be ignored.