2016年重庆市合川区人民医院细菌耐药性监测结果分析

Analysis on bacterial drug resistance in Hechuan District People's Hospital during 2016

目的分析该院2016年临床分离菌的分布和耐药特征,为临床抗菌药物合理应用提供病原菌耐药监测数据。方法对临床送检标本按常规方法进行病原菌分离,采用Vitek2-Compact系统进行鉴定,药敏试验方法采用MIC法及KB法,按照美国临床实验室标准化研究所(CLSI)相关标准进行。采用WHONET5.6软件进行数据统计分析。结果 2016年共分离出非重复病原菌2 214株。其中革兰阴性杆菌1 614株(占72.9%),革兰阳性菌600株(占27.1%)。前5位分离菌分别为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、金黄色葡萄球菌。产超广谱β-内酰胺酶大肠埃希菌、肺炎克雷伯菌检出率分别为51.8%、27.6%,耐甲氧西林金黄色葡萄球菌检出率为26.5%。未发现对利奈唑胺和万古霉素耐药的葡萄球菌。结论该院病原菌以革兰阴性杆菌为主,医院应强化合理规范用药,减少耐药菌株的产生。

Objective To analyze the clinically isolated bacterial distribution and drug resistance characteristics in the our hospital during 2016 to provide the pathogenic drug resistance monitoring data for rational bacterial drugs use in clinic. Methods The clinicaly submitted samples were performed the pathogenic bacterial isolation according to the routine method. The isolated pathogens were identified by the Vitek2-Compact system and the drug susceptibility test was performed by adopting the MIC and KB methods. The results were statistically analyzed by adopting the WHONETS. 6 software. Results A total of 2 214 non-repeat strains of bacteria were isolated in 2016, including 1 614 strains of Gram-negative bacilli,accounting for 72. 9%, 600 strains of Gram-positive bacteria,accounting for 27.1%. The top five isolated bacteria were Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobaeter baumannii and Staphylococcus aureus. The detection rates of ESBLs producing Escherichia coli and Klebsiella pneumoniae were 51. 8% and 27. 6% respectively. The detection rates of methicillin-resistant Staphylococcus aureus （MRSA） was 26.5%. No vancomycin or linezolid resistant staphylococcal strains were found. Conclusion The main isolated pathogens in our hospital are dominated by Gram-negative bacteria. Hospital should strengthen reasonable and standardized use of anti- bacterial drugs to reduce the generation of drug resistant bacterial strains.