2018年某三甲综合医院临床分离株分布及耐药性分析

The distribution and drug resistance analysis of clinical isolates in a Class-A comprehensive hospital in 2018

目的了解2018年嘉兴市第一医院临床分离株的分布和耐药情况,为临床合理使用抗菌药物、有效防治多重耐药菌(MDROs)感染提供依据。方法回顾性收集2018年1月1日-12月31日该院临床分离株,进行菌株培养、鉴定及药敏试验。结果 2018年共收集非重复临床分离株8 646株,其中革兰阴性菌5 618株(64.98%),数量分离前4位的分别为大肠埃希菌、克雷伯菌属、不动杆菌属和铜绿假单胞菌;革兰阳性菌2 250株(26.02%),数量分离前4位的分别为金黄色葡萄球菌、粪肠球菌、凝固酶阴性葡萄球菌和屎肠球菌。大肠埃希菌对阿米卡星、哌拉西林/他唑巴坦、碳青霉烯类抗菌药物敏感率较高(> 95%),ESBL阳性率为42.07%;肺炎克雷伯菌对多数抗菌药物敏感,ESBL阳性率为18.14%。结论细菌耐药性仍对临床抗感染治疗构成严重威胁,需要继续加强感染防控工作,临床应重视细菌耐药性监测,并根据药敏试验结果合理使用抗菌药物。

Objective To understand the distribution and drug resistance of clinical isolates in the First Hospital of Jiaxing in 2018,and to provide basis for rational use of antibiotics and effective prevention and treatment of multi-drug resistant bacteria(MDROs)infection.Methods The clinical isolates in the First Hospital of Jiaxing from January 1,2018 to December 31,2018 were retrospectively collected for culture,identification and drug sensitivity test.Results A total of 8646 non-repetitive clinical isolates were collected in 2018,including 5618 Gram-negative bacteria(64.98%),and 2250 Gram-positive bacteria(26.02%).The top four isolates of Gram-negative bacteria were Escherichia coli,Klebsiella,Acinetobacter and Pseudomonas aeruginosa.The top four isolates of Gram-positive bacteria were Staphylococcus aureus,Enterococcus faecalis,Coagulase negative staphylococcus and Enterococcus faecium Escherichia coli was more susceptible to Amikacin,Piperacillin/tazobactam and Carbapenems(>95%),and the positive rate of ESBL was 42.07%.Klebsiella pneumoniae was sensitive to most antibiotics,and the positive rate of ESBL was 18.14%.Conclusion Bacterial resistance is still a serious threat to clinical anti-infective treatment,and it's necessary to keep strengthening the infection prevention and control.Clinical monitoring of bacterial resistance should be emphasized,and rational use of antibiotics should be based on the results of drug sensitivity test.