医院2013年至2016年临床分离菌耐药性分析

Resistance Analysis of Clinical Isolated Bacteria from 2013 to 2016 in a Hospital

目的了解医院2013年至2016年住院患者中病原菌分布及耐药性变迁趋势,为临床抗感染治疗提供依据。方法对医院2013年至2016年住院患者的所有送检标本进行病原菌培养,采用Walk Away-40 Plus型全自动细菌分析仪进行鉴定和药物敏感性试验,按2015年美国临床和实验室标准协会(CLSI)标准对检出病原菌进行回顾性分析。结果 4年共分离出病原菌3 171株,包括革兰阴性杆菌1 358株,占42.83%,其中数量居前3位的是大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌;革兰阳性球菌1 145株,占36.11%,其中数量居前3位是凝固酶阴性葡萄球菌、金黄色葡萄球菌和肠球菌;真菌668株,占21.06%。大肠埃希菌和肺炎克雷伯菌中,超广谱β-内酰胺酶(ESBLs)的平均检出率分别为38.87%和18.23%;肠杆菌科细菌对氨苄西林的耐药率较高,对阿米卡星、哌拉西林他唑巴坦、亚胺培南的耐药率较低。金黄色葡萄球菌和凝固酶阴性葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)的平均检出率分别为44.74%和60.37%,未发现万古霉素耐药的葡萄球菌。结论医院住院患者感染以革兰阴性杆菌为主,细菌耐药情况比较显著,需引起高度重视。

Objective To understand the distribution of pathogenic bacteria and the trend of drug resistance changes in hospitalized patients in our hospital from2013to2016,so as to provide the basis for clinical anti-infection treatment Methods All the specimens of hospitalized patients in hospital from2013to2016were routinely cultivated for pathogenic bacteria,and the Walk Away-40Plus automatic bacterial analyzer was used for identification and drug sensitivity test.The pathogenic bacteria were retrospectively analyzed according to the standard of Clinical and Laboratory Standards Institute(CLSl)in2015.Results A total of3171pathogenic bacteria were isolated in4years,of which1358strains of gram-negative bacteria(42.83%),and the top three were Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa.Totally1145strains gram-positive coccus were isolated(36.11%),and the top three were Coagulase negative staphylococcus,Staphylococcus aureus and Enterococcus.Totally668strains were fungus(21.06%).The average detection rates of ESBLs in Escherichia coli and Klebsiella pneumoniae were38.87%and18.23%,respectively.The resistance rate ofEnterobacteriaceae to ampicillin was higher,and it was lower to amikacin,piperacillin tazobactam and imipenem.The average detectionrate of MRSA in Staphylococcus aureus was44.74%,and the average detection rate of MRCNS in Coagulase negative staphylococcus was60.37%,respectively.No Staphylococcus was found to be resistant to vancomycin.Conclusion The infection of hospital inpatients is mainly gram-negative bacilli,and the drug resistance of the bacteria is very significant.It should be paid more attention to.