丽水地区2017年细菌耐药监测分析

Monitoring and analysis of antimicrobial resistance in Lishui, 2017

目的了解丽水地区2017年临床分离菌株对常用抗菌药物的耐药情况。方法对丽水地区12所医院临床分离菌采用K-B法或自动化仪器法进行药敏试验,按CLSI 2017年标准判断结果,采用WHONET 5.6软件进行统计分析。结果本次监测共分离细菌15463株;排名前5位的细菌依次为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌;耐甲氧西林金黄色葡萄球菌(MRSA)检出率为31.0%;未发现对万古霉素耐药的金黄色葡萄球菌;大肠埃希菌和肺炎克雷伯菌中ESBL检出率为46.4%和29.0%;肺炎克雷伯菌近年来的分离率及耐药率呈稳步上升趋势;非发酵菌对碳青霉烯类药物的耐药率较高。结论临床分离菌对常见抗菌药物的耐药较为严重,尤其是耐碳青霉烯类的肺炎克雷伯菌;在继续做好细菌耐药监测工作的同时加强微生物实验室与临床的沟通与合作,发挥耐药监测的指导作用,共同遏制耐药菌的传播。

Objective To investigate the drug resistance of the clinical isolates from Lishui area in 2017.Methods Twelve hospitals were involved in this program.Antimicrobial susceptibility testing was carried out according to Kirby-Bauer method or automated systems.Results were analyzed by software WHONET 5.6 according to CLSI 2017.Results A total of 15463 clinical isolates were collected;The top 5 isolates were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Pseudomonas aeruginosa and Acinetobacter baumanni;The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)was 31.0%;No S.aureus strains were found resistant to vancomycin;ESBLs-producing strains accounted for 46.4%in E.coli and 29.0%in K.pneumoniae;The prevalence and resistance rates of K.pneumoniae were ascending.recently;The resistance rate of non-fermenting bacteria to carbapenems was generally high.Conclusion Bacterial resistance is still severe,especially the CRKP;It is necessary to strengthen the communication and cooperation of laboratories and clinicians,and the surveillance data should be used to prevent the spread of drug-resistant bacteria.