摘要
目的了解蚌埠市第一人民医院多重耐药菌的分布及耐药情况,为多重耐药菌的控制和预防提供依据。方法回顾性分析蚌埠市第一人民医院2015年1月1日至2017年12月31日分离到的790株多重耐药菌,对产超广谱β内胺酶(ESBLs)大肠埃希菌、产超广谱β内胺酶(ESBLs)肺炎克雷伯氏菌、耐甲氧西林金黄色葡萄球菌(MRSA)、耐碳青霉烯酶的鲍曼不动杆菌(CR-AB)统计其标本来源和种类,按年份分析其检出率及耐药性。结果产ESBLs的大肠埃希菌和肺炎克雷伯菌547株,CR-AB 142株,MRSA 101株,共计790株,占总分离株的23.3%;标本来源科室主要有普外科、重症监护病房、泌尿外科、呼吸内科;标本种类主要有痰、血液、尿液、脓液;产ESBLs的大肠埃希菌和肺炎克雷伯菌近三年对氨苄西林、哌拉西林、头孢噻肟、头孢唑肟的耐药率都在90.0%以上,氨曲南的耐药率也在70.0%以上,亚胺培南和美罗培南的敏感率均在99.0%以上;近三年间MRSA对阿米卡星保持较低的耐药率(4.0%~9.4%),庆大霉素、环丙沙星的耐药率在15.0%~32.0%之间,替考拉宁、利奈唑胺、万古霉素尚未发现耐药株;2015—2017年CR-AB除了对头孢哌酮舒巴坦耐药率相对较低之外,对其他主要抗生素的耐药性几乎达到90.0%以上,多黏菌素未发现耐药株。结论蚌埠市第一人民医院细菌耐药情况依然严峻,必须采取多种措施,严格遏制多重耐药菌的扩散和传播。
Objective To investigate the distribution and drug resistance of multidrug-resistant bacteria in The First People's Hospital of Bengbu,and to provide basis for the control and prevention of multidrug-resistant bacteria.Methods A total of 790 isolates of multidrug-resistant bacteria in The First People's Hospital of Bengbu from January 1,2015 to December 31,2017 were retrospectively analyzed,including the Escherichia coli and Klebsiella pneumoniae producing extended-spectrum beta lactamase(ESBLs),methicillin-resistant Staphylococcus aureus(MRSA),and carbapenem-resistant Acinetobacter Bauman(CR-AB).The sources and types of samples were counted and the detection rate and drug resistance rate were analyzed by year.Results There were totally 790 strains,including 547 strains of Escherichia coli and Klebsiella pneumoniae producing ESBLs,142 strains of CR-AB,and 101 strains of MRSA,accounting for 23.3%of the total isolates.The main sources of the specimens were department of general surgery,ICU,department of urology surgery and department of respiratory medicine.The types of specimens mainly included phlegm,blood,urine,and pus.The rate of Escherichia coli and Klebsiella pneumoniae producing ESBLs resistant to Ampicillin,Piperacillin,Cefotaxime and Cefazolin in recent three years was more than 90.0%.The resistance rate of Aztreonam was more than 70.0%.The sensitivity rates of Imipenem and Meropenin were both above 99.0%.MRSA maintained a low resistance rate to Amikacin(4.0%to 9.4%)in recent three years.The resistance rates of Gentamicin and Ciprofloxacin were in the range from 15.0%to 32.0%.Resistant strains of Teicoplanin,Linezolid and Vancomycin were not found.In recent three years,CR-AB had a relatively low resistant rate to Cefoperazone and Sulbactam,but its resistant rate to other main antibiotics had almost reached more than 90.0%.No resistant strain was found for Polymyxin.Conclusions The bacterial resistance in The First People's Hospital of Bengbu is still severe,and a variety of measures must be taken to strictly curb the spread of multidrug-resistant bacteria.
作者
段友红
张梦兰
夏新红
常滋毓
陈尧
梁友宝
DUAN Youhong;ZHANG Menglan;XIA Xinhong;CHANG Ziyu;CHEN Yao;LIANG Youbao(Department of Laboratory Medicine,The First People's Hospital,Bengbu,Anhui 233000,China)
出处
《安徽医药》
CAS
2019年第2期399-402,共4页
Anhui Medical and Pharmaceutical Journal
关键词
多重耐药菌
监测
抗菌药物
Multidrug-resistant bacteria
Monitoring
Antibiotic