华中阜外医院建院第一年细菌耐药性分析

Antimicrobial resistance surveillance of Central China Fuwai Hospital in its first year

目的了解华中阜外医院建院第一年临床菌株的分布及对常用抗菌药物的耐药性。方法收集该医院2018年1~12月的所有临床分离菌株,用自动化仪器法结合纸片扩散法进行药物敏感性试验,采用WHONET 5.6、SPSS 20.0和Prism 7.0软件进行数据分析。结果共收集非重复菌株793株,其中革兰氏阳性菌194株,占24.46%,革兰氏阴性菌599株,占75.54%。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为57.4%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率为89.1%。肺炎克雷伯菌和大肠埃希菌超广谱β-内酰胺酶(ESBLs)的检出率分别为54.0%和76.0%,对碳青霉烯类耐药率分别为30.3%和5.6%。铜绿假单胞菌和不动杆菌属对碳青霉烯类耐药率分别为26.5%和77.2%。多重耐药菌检出率最高的科室分别为冠心病ICU、胸外科和综合ICU。结论该医院分离的菌株对重点监测药物耐药率较高,应在做好细菌耐药监测工作的同时,加强医院感染控制措施并合理使用抗菌药物,减少耐药菌株的传播流行。

Objective To investigate the resistance profile of clinical isolates to commonly used antibiotics collected from Central China Fuwai Hospital in its first year.Methods All the clinical isolates were collected from January,2018 to December,2018,and automated systems and disc diffusion testwere employed to test the antimicrobial susceptibility,the results were analyzed by WHONET 5.6,SPSS20.0 and Prism7.0 software.Results A total of 793 non-repetitive isolates were collected during 2018,including 194(24.46%)Gram-positive bacteria and 599(75.54%)Gram-negative bacteria.The prevalence of methicillin-resistant strains was 57.4%in Staphylococcus aureus(MRSA)and 89.1%in coagulase negative Staphylococcus(MRCNS).Extended-spectrum beta-lactamase(ESBLs)producing rate in Klebsiella pneumonia and Escherichia coli were 54.0%and 76.0%respectively,and the resistance rate to carbapenems were 30.3%and 5.6%respectively.The resistance rate to carbapenems of Pseudomonas aeruginosa and Acinetobacter spp.were 26.5%and 77.2%respectively.Departments with the ratio of multi-drug resistant bacteria ranked top 3 is Coronary ICU,Chest surgery and General ICU.Conclusion The bacterial resistance is relatively high in the hospital.It is necessary to strengthen hospital infection control and rational use antibiotics in addition to surveillance of bacterial resistance.