2015—2017年某三级医院呼吸内科细菌耐药性监测

Surveillance of Bacterial Resistance in Respiratory Department of a Grade Three Hospital From 2015 to 2017

目的了解三级医院呼吸内科分离菌对常用抗菌药物的耐药性。方法临床分离菌采用MIC法按统一方案进行细菌药物敏感试验,结果按临床实验室标准研究所(Clinical and Laboratory Standards Institute,CLSI)2017年版标准判断。结果 2015年1月—2017年12月收集呼吸内科临床分离菌共1428株,其中革兰阳性菌占22.3%,革兰阴性菌占77.7%。金黄色葡萄球菌中甲氧西林耐药株(MRSA)为29.7%。大肠埃希菌、肺炎克雷伯菌中产ESBLs株分别为52.6%和33.1%。流感嗜血杆菌对复方磺胺甲噁唑耐药率高达81.3%。铜绿假单胞菌对亚胺培南和美罗培南耐药率分别为25.7%和14.0%,鲍曼不动杆菌对两者的耐药率均是73.0%。结论呼吸内科细菌耐药性严重,尤其是多重耐药菌对临床构成严重威胁。合理选用抗菌药物,加强感染控制措施是当务之急。

Objective To analyze the resistance of bacteria isolated from respiratory department of a three grade hospital to commonly used antibiotics. Methods The clinical isolates were tested by the MIC method according to the unified plan, and the results were judged according to the 2017 edition of CLSI standard. Results From January 2015 to December 2017, 1428 clinical isolates of respiratory medicine were collected, of which gram positive bacteria accounted for 22.3% and Gram-negative bacteria accounted for 77.7%. Methicillin resistant strain （MRSA） of Staphylococcus aureus was 29.7%. The ESBLs strains of Escherichia coli and Klebsiella pneumoniae were 52.6% and 33.1% respectively. The resistance rate of Haemophilus influenzae to compound sulfamethoxazole was as high as 81.3%. The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 25.7% and 14% respectively, and the resistance rates ofAcinetobacter Bauman to both were 73.0%. Conclusion Bacterial resistance is serious in respiratory department, especially for multi drug resistant bacteria. It is urgent to choose antibiotics rationally and strengthen infection control measures.