惠州地区3家综合医院2015～2016年细菌耐药情况分析

Analysis of Bacterial Resistance in 3 Hospitals from Huizhou City 2015 to 2016

目的:了解2015~2016年惠州地区三家综合医院临床分离菌的分布和耐药特征,指导临床合理使用抗菌药物。方法:收集惠州地区3家综合医院临床分离菌及其药敏试验结果,对细菌类型分布、菌株来源分布、细菌耐药结果等数据采用WHONET 5.6软件进行统计分析。结果:2015~2016年3家医院临床分离株共25 193株,革兰阳性菌和格兰阴性菌分别占25.3%和74.7%。葡萄球菌中耐甲氧西林金葡菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为38.4%和80.6%,未检测出对利奈唑胺和万古霉素耐药的葡萄球菌属。肠杆菌科细菌对亚胺培南的敏感率达98.4%。肠球菌中发现0.4%对万古霉素耐药菌株。非发酵菌对9种抗菌药物敏感率均超过60%,其中铜绿假单胞菌对阿米卡星和庆大霉素的敏感率超过了90%;铜绿假单胞菌其对抗菌药物的耐药率明显低于不动杆菌。结论:耐甲氧西林葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌仍是革兰阳性茵中所占比例最高的细菌,碳青霉烯类药物对肠杆菌科细菌虽保持较高的活性,但是敏感率已经有所下降。对细菌耐药性进行定期监测,有助于了解惠州地区病原菌构成及细菌耐药性的变迁,从而为临床合理用药提供理论依据。

Objective： To investigate the distribution and antimicrobial resistance spectrum of clinical bacterial isolates in three hospitals from Huizhou City,2015-2016,thus guided rational use of antibiotics clinically. Methods： The antibiotic sensitivity of bacteria isolated from three hospitals in Huizhou were collected,the types of bacterial,origin of isdates,status of drug resistance were analyzed by WHONET 5. 6 software statisitically. Results： A total of 25 193 pathogenic strains were clinically isolated in those three hospitals from 2015 to 2016,25. 3% and 74. 7% of which were gram-positive and gram-negative bacteria respectively. Detection rates of methicillin resistant Staphylococcus aureus（ MRSA） and methicillin-resistant coagulase-negative Staphylococci（ MRCNS） were 38. 4% and 80. 6% respectively and no strain of Staphylococcus resistant to vancomycin or linezolid was found. The sensitive rates of the Enterobacteriaceae to imipenem reached98. 4%. In Enterococcus spp,vancomycin resistant strains accounted for 0. 4%. The sensitive rates of the fermentation bacteria to all 9 kinds of drugs were over 60%. From them,Pseudomonas aeruginosa,sensitive rates of which to amikacin and gentamycin were over 90%,had a much lower drug resistance rate to antibiotics than Acinetobacter. Conclusion： Methicillin resistant Staphylococcus aureus（ MRSA） and methicillin-resistant coagulase-negative Staphylococci（ MRCNS） were grampositive bacteria which still had a Highest proportion. Carbapenem antibiotic was still highly reactive to Enterobacteriaceae bacteria but drug resistance rate increased slightly. Periodic monitoring of bacterial resistance contributed to understand the changes of the composition of pathogenic bacteria and bacterial resistance in Huizhou thus provided a theoretical basis for rational antimicrobial therapy.