2015年江西抚州市第一人民医院临床分离菌耐药性分析

Antimicrobial resistance profile of the clinical isolates in Fuzhou First People's Hospital,Jiangxi during 2015

目的了解江西省抚州市第一人民医院2015年临床分离菌分布及耐药状况。方法采用ATB Reader半自动仪器比色法进行菌种鉴定,纸片扩散法进行药敏试验,参照CLSI 2015年版标准判读结果,WHONET5.5软件进行数据分析。结果该院2015年共收集非重复临床分离菌1 215株,其中革兰阴性菌858株,占70.6%,革兰阳性菌357株,占29.4%。耐甲氧西林金黄色葡萄球菌(金葡菌,MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分别占金葡菌和凝固酶阴性葡萄球菌的50.0%和84.1%;MRSA对红霉素高度耐药、对四环素和诺氟沙星耐药率均为80.3%,未见耐万古霉素和替考拉宁葡萄球菌。大肠埃希菌和肺炎克雷伯菌中产ESBL株分别占52.5%和34.7%;检出碳青霉烯类耐药肠杆菌科细菌10株。铜绿假单胞菌对阿米卡星、头孢哌酮-舒巴坦、美罗培南和妥布霉素的耐药率均低于10%。鲍曼不动杆菌对黏菌素和头孢哌酮-舒巴坦的耐药率分别为2.4%和51.8%,对其他常用抗菌药物的耐药率均在75%以上。结论该院临床分离菌以革兰阴性杆菌为主,细菌耐药性仍是临床重要问题,应引起临床高度重视。

Objective To investigate the antimicrobial resistance profile of clinical isolates in Fuzhou First People＇s Hospital during 2015. Methods The bacterial isolates were identified using ATB Reader semi-automatic equipment via colorimetric method. The antimicrobial susceptibility was tested by disk diffusion method. The results were interpreted according to the CLSI breakpoints issued in 2015. All data were analyzed by WHONET 5.5 software. Results A total of 1 215 non-duplicate clinical isolates were collected during 2015, including gram negative bacteria （70.6 %） and gram positive bacteria （29.4 %）. The prevalence of MRSA was 50.0 % in S. aureus and the prevalence of MRCNS was 84.1% in coagulase-negative Staphylococcus. Most MRSA strains （80.3 %） were resistant to erythromycin, tetracycline and norfloxacin. No staphylococcal isolate was found resistant to vancomycin or teicoplanin. The prevalence of ESBLs was 52.5 % in E. coli and 34.7 % in K. pneumoniae. Ten strains of Enterobacteriaceae were resistant to carbapenems. Less than 10 % of the P aeruginosa isolates were resistant to amikacin, cefoperazone-sulbactam, meropenem and tobramycin. About 2.4 % and 51.8 % of the Acinetobacter isolates were resistant to polymyxin E and cefoperazone-sulbactam, respectively, while more than 75 % of these strains were resistant to other commonly used antimicrobial agents. Conclusions Most of the clinical isolates are gram-negative bacilli in our hospital during 2015. Antimicrobial resistance remains an important clinical concern, which should be addressed seriously.