武汉市某医院临床病原微生物的分布及耐药性监测

Distribution and bacterial resistance surveillance of clinical pathogenic microorganisms in a hospital in Wuhan

目的了解武汉大学人民医院临床分离病原微生物的分布及对常用抗菌药物的敏感性,为临床预防性使用抗菌药物及医院感染控制提供理论依据。方法采用全自动细菌鉴定药敏系统BD-Phoenix-100对所有分离菌株进行鉴定和药物敏感性测试。结果 2017年2月至2018年2月武汉大学人民医院共分离临床病原微生物8 380株,其中革兰阳性菌占40.5%,革兰阴性菌占59.5%。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的检出率为44.6%,对复合制剂氨苄西林/舒巴坦和阿莫西林/克拉维酸处于中介的菌株分别占37.9%和30.2%。耐甲氧西林金黄色葡萄球菌(MRSA)检出率为40.0%,未分离出对万古霉素、替考拉宁和利奈唑胺耐药的菌株。碳青霉烯耐药鲍曼不动杆菌(CRAB)检出率为70.7%,CRAB和碳青霉烯耐药铜绿假单胞菌(CRPA)对黏菌素的敏感率超过99.0%,碳青霉烯耐药肠肝菌科细菌(CRE)对替加环素的敏感率为100.0%。结论该院临床重要耐药菌株的检出率较高,耐药菌株的出现为临床抗感染治疗带来挑战,应积极采取感染控制措施。

Objective investigate the distribution of pathogenic microorganisms and the sensitivity to commonly used antimicrobial agents in Renmin Hospital of Wuhan University,and to provide theoretical basis for clinical preventive use of antimicrobial agents and hospital infection control. Methods All separating iso- lates were identified and tested by automatic bacteria identification and drug susceptibility systems BD-Phoe- nix-100. Results From February 2017 to February 2018,8 380 clinical pathogenic microorganisms were isola ted from Renmin Hospital of Wuhan University of which there were gram-positive bacteria accounting for a- bout 40.5 % ,and gram-negative bacteria,accounting for 59.5% The detection rate of ESBLs-producing Esche- richia coli was 44.6% ,and the intermediary rate of ampicillin/sulbactam and amoxicillin/clavulanic acid were 37.9 % and 30.2%, respectively. The detection rate of MRSA was 40.0% ,and strains resistant to vancomy- cin,teicoplanin and linezolid were not isolated. The detection rate of CRAB was 70.7% and the sensitivity of CRAB and CRPA to colistin was more than 99.0% ,and the sensitivity of CRE to tigecycline was 100.0%. Conclusion The detection rate of drug-resistant strains is high in our hospital,and the emergence of drug-re sistant strains is a challenge to clinical anti-infective treatment,We should take measures of infection control.