贵州省七家医院细菌分布情况对比及我院耐药性监测报告

Comparison of Bacterial Resistance Among 7 Hospitals in Guizhou Province and Analyzed the Results of Bacterial Resistance Monitoring in my Hospital

目的比较贵州省细菌耐药监测网2017年10月—2018年9月七家成员单位耐药情况,并分析某院细菌耐药性监测结果。方法根据耐药监测网监测方案,使用标准纸片扩散法或自动化仪器检测法,根据CLSI 2017年标准判断结果,用WHONET5.6软件及SPSS 23.0进行统计分析。结果七家成员单位共分离出病原菌58565株,其中重复菌株占24.12%;革兰阴性菌中大肠埃希菌的分离率最高,革兰阳性菌中金黄色葡萄球菌分离率最高。耐碳青霉烯类大肠埃希菌和肺炎克雷伯菌的平均检出率为1.20%和5.68%;耐碳青霉烯类铜绿假单胞菌和鲍曼不动杆菌的平均检出率为15.13%和47.18%;耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌平均检出率为32.34%和81.38%。某院细菌耐药监测结果显示,大肠埃希菌和肺炎克雷伯菌对头孢菌素、青霉素类、喹诺酮类药物耐药性较高;鲍曼不动杆菌对除替加环素的其他药物耐药性普遍较高;铜绿假单胞菌对头孢哌酮/舒巴坦、阿米卡星有较高敏感性,未发现对利奈唑胺、万古霉素耐药的金黄色葡萄球菌。结论长期和连续性得监测不同地区细菌耐药性有助于了解当地病原菌的构成及细菌耐药性的变迁。做好细菌耐药监测工作的同时也应加强实验室与临床的沟通,为临床上合理使用药物提供理论依据,最大限度地发挥出细菌耐药性监测工作的价值。

Objective Integrated analysis of drug resistance of seven member units from October 2017 to September 2018 in Guizhou provincial bacterial resistance monitoring network.Then analyzed the results of bacterial resistance monitoring in my hospital.Methods According to the monitoring scheme of drug resistance monitoring network,standard paper diffusion method or automated instrument detection method were used.On the basis of criteria of the CLSI 2017 standard judgment results,WHONET 5.6 software and SPSS 23.0 were used for statistical analysis.Results A total of 58565 pathogenic bacteria were isolated from the seven member units,of which 24.12%were duplicated.The isolation rate of Escherichia coli was the highest in Gram-negative bacteria.The isolation rate of Staphylococcus aureus was the highest in Gram-Positive bacteria.The average detection rates of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae were 1.20%and 5.68%respectively.The average detection rates of Carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii were 15.13%and 47.18%respectively.The average detection rates of Methicillin-resistant Staphylococcus aureus and coagulase negative Staphylococcus were 32.34%and 81.38%respectively.The results of bacterial resistance monitoring in a hospital showed that Escherichia coli and Klebsiella pneumoniae were highly resistant to cephalosporins,penicillins and quinolones;Acinetobacter baumannii generally had high resistance to other drugs except Tegacycline.Pseudomonas aeruginosa was highly sensitive to cefoperazone/sulbactam and amikacin;No strains of Staphylococcus aureus resistant to linezolid and vancomycin were found.Conclusion Long-term and continuous monitoring of bacterial resistance in different places helps to understand the composition of local pathogens and the evolution of in bacterial resistance.While doing a good job in monitoring bacterial resistance,we should also strengthen the communication between the laboratory and the clinic,so as to provide a theoretical basis for the rational use of drugs in clinical practice and give full play to the value of bacterial resistance monitoring.