2017年山西省肿瘤医院细菌耐药监测报告

The monitoring report of bacterial drug resistance in Shanxi Cancer Hospital in 2017

目的统计山西省肿瘤医院2017年临床分离菌株的分布及耐药情况,并与山西省及全国耐药监测网的数据进行比较,得出医院的耐药性分析,为临床一线医务人员初期经验用药提供帮助。方法采用标准纸片扩散法,即K-B法对本院分离的菌株进行药敏试验,依据美国临床实验室标准协会即CLSI 2016年M100-S23版敏感性折点标准判读结果,并用WHONET 5.6进行统计分析。结果本院送检标本共13329份,分离菌株共1602株,前5位菌株依次是大肠埃希菌(27.0%)、肺炎克雷伯菌(18.9%)、铜绿假单胞菌(12.5%)、阴沟肠杆菌(6.3%)、金黄色葡萄球菌(5.4%)。MASA检出率为9.3%,未发现对万古霉素、利奈唑胺耐药的葡萄球菌。粪肠球菌多于屎肠球菌,并且耐药率明显低于屎肠球菌。结论山西省肿瘤医院患者的细菌耐药性仍很严重,应重视细菌耐药性监测并加强临床抗生素的合理应用。

Objective The distribution and drug resistance of clinical isolates in Shanxi Cancer Hospital in 2017 were statistically analyzed,and the data from Shanxi Province and the national drug resistance monitoring network were compared to perform the drug resistance analysis,so as to provide help for clinical medical staff in the initial experience of drug use.Methods Standard disc-diffusion method,namely K-B method,was adopted to test the bacteria's sensitivity against antimicrobial drugs.The date was analyzed by WHONET 5.6 based on CLSI 2016 M100-S23.Results A total of 13329 specimens were sent to our laboratory,and 1602 strains were isolated.The top five strains were Escherichia coli(27.0%),Klebsiella pneumoniae(18.9%),Pseudomonas aeruginosa(12.5%),Enterobacter cloacae(6.3%)and Staphylococcus aureus(5.4%).The detection rate of MASA was 9.3%,and vancomycin and linezolid-resistant Staphylococcus was not detected.Enterococcus faecalis is more than Enterococcus faecium,and the drug resistance rate is lower than Enterococcus faecium.Conclusion The bacterial resistance in Shanxi Cancer Hospital is still very serious.We should pay more attention to the monitoring of bacterial resistance and strengthen the rational application of clinical antibiotics.