2014年新疆维吾尔自治区人民医院细菌耐药性监测

Antibiotic resistance profile of the bacterial isolates in People's Hospital of Xinjiang Uygur Autonomous Region during 2014

目的分析2014年新疆维吾尔自治区人民医院临床分离菌对常用抗菌药物的耐药性。方法采用全自动微生物分析仪VITEK2-Compact进行细菌鉴定，药敏试验采用VITEK-AMS药敏卡及纸片扩散法。采用WHONET5．6软件进行数据的统计分析。结果2014年共检出6503株细菌，革兰阳性菌1590株，其中耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌在各自菌种中检出率分别为31．8％和81．9％；青霉素不敏感肺炎链球菌为9．6％，其中耐药的发生率为6．0％，中介为3．6％。革兰阴性杆菌4913株；肠杆菌科细菌2927株，其中克雷伯菌属、肠杆菌属、枸橼酸菌属、沙霄菌属对碳青霉烯类（亚胺培南和美罗培南）抗生素的耐药率在1．3％～10．6％；不发酵糖革兰阴性杆菌1986株，不动杆菌属仅对米诺环素和头孢哌酮-舒巴坦的耐药率相对较低，分别为32．8％和37．1％，对亚胺培南和美罗培南的耐药率已高达75.2％、79．9％。此年共分离泛耐药不动杆菌563株（45．6％），该院鲍曼不动杆菌以携带6肠OXA-23基因为主，嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌对所测药物均具有较高的敏感率。结论2014年细菌耐药性监测表明，临床分离菌对所测抗菌药物均具有不同程度的耐药甚至出现泛耐药菌株，医院应重视耐药菌株的监测，严格做好医护人员手卫生及无菌技术操作，加强感染管理和预防，以减缓耐药菌的产生。

Objective To examine the resistance profile of clinical bacterial isolates in People＇s Hospital of Xinjiang Autonomous Region during 2014. Methods Automatic microorganism analyzer VITEK 2-Compact was used to identify the isolates. Antimicrobial susceptibility testing was conducted using VITEK-AMS drug sensitivity cards and Kirby-Bauer method. The data were analyzed with WHONET 5.6 software. Results A total of 6 503 strains of bacteria were isolated in 2014, 1 590 of which were gram-positive bacteria, and 4 913 were gram-negative strains. The prevalence of methieillin-resistant S. aureus, methieillin-resistant coagulase negative Staphylococcus, and penicillin non-susceptible S. pneumoniae was 31.8 %, 79.4 % and 9.6 %, respectively. The prevalence of penicillin-resistant S. pneumoniae and penicillin-intermediate S. pneumoniae was 6.0 % and 3.6 %, respectively. The gram-negative bacteria strains included 2 927 strains of Enterobacteriaceae and 1 986 strains of non-fermenting gram-negative bacteria. About 1.3 % to 10.6% of the Klebsiella, Enterobacter, Citrobacter, and Serratia strains were resistant to imipenem andmeropenem. A. baumannii showed relatively lower resistance rates to minocycline （32.8 %） and cefoperazone-sulbactam （37.1%）, but higher resistance to imipenem （75.2 %） and meropenem （79.9 %）. A total of 563 （45.6 %） strains of extensively drug-resistant bacteria were isolated in 2014. The beta-lactamase gene in A. baumannii was primarily blaOXA-23 type. S. maltophilia and B. cepacia isolates were relatively susceptible to the antimicrobial agents tested. Conclusions The results indicate that the clinical isolatedbacteria have various degrees of resistance to the commonly used antimicrobial agents. Extensively drug-resistant bacterial strains were also identified in 2014. Healthcare professionals should pay attention to good hand hygiene and strict aseptic techniques, and make efforts to control hospital infections.