2017年临床分离常见细菌耐药性监测报告

Analysis of antimicrobial resistance of clinical isolated bacteria in 2017

目的:分析临床分离病原菌的构成及耐药性,为临床医师合理选择抗菌药物提供参考。方法:收集2017年临床分离的主要病原菌,所有菌株采用Vitek2-compact系统进行鉴定及药敏试验,用纸片扩散法(K-B法)加以补充。采用Whonet5.6软件分析数据。结果:共收集非重复细菌1 032株。其中革兰阳性菌占32.7%,革兰阴性菌占67.3%。革兰阳性菌不同菌种的耐药谱明显不同,但未发现对万古霉素耐药菌株。耐甲氧西林金黄色葡萄球菌(MRSA)检出率为21.2%;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率高于71.9%。分离肠杆菌科细菌对碳青霉烯类抗菌药物的耐药率普遍较低(<1.6%);耐碳青霉烯类铜绿假单胞菌和耐碳青霉烯类鲍曼不动杆菌检出率分别为27.8%和49.2%;洋葱伯克霍尔德菌对美罗培南的耐药率为33.3%。结论:临床医师应及时掌握本院病原菌分布及耐药性数据,合理使用抗菌药物,遏制细菌耐药性的进一步蔓延。

Objective:To investigate the distribution and antimicrobial resistance of main bacteria isolated from clinical,so as to provide a reference for clinicians to choose antimicrobial agents.Methods:Collect main pathogens isolated from all kinds of specimens in hospital in 2017,all isolates identified using Vitek2-compact automated microorganism.Drug susceptibility test was performed by Vitek2-compact,and Kirby-Bauer(K-B)test was used to supplement it.The data were analyzed by WHONET 5.6 software.Results:A total of 1 032 non-duplicated strains were isolated in clinical,which included 32.7%Gram-positive bacteria and 67.3%Gram-negative bacteria.The drug resistant spectrums of Gram-positive bacteria were significantly different,but no strains resistant to vancomycin were found.The detected rates of the meticillin-resistant S.aureus(MRSA)was 21.2%.The detected rates of the meticillin-resistant coagulase-negative staphylococci(CNS)was above 71.9%.The drug resistance rate of Enterobacteriaceae bacteria for carbapenems is generally very low(<1.6%),The drug resistance rates of P.aeruginosa and A.baumannii to carbapenems were 27.8%and 49.2%.The drug resistance rates of B.cepacia to Meropenem was 33.3%.Conclusion:Clinicians should know the latest trends of the pathogens and drug resistance,and reasonable use of antibiotics is important for the containment of further spread of drug resistance.