2018年医院病原菌分布及耐药性监测

Distribution of pathogenic bacteria and drug resistance monitoring in hospital in 2018

目的:了解2018年医院临床分离菌对常用抗菌药物的耐药性。方法:采用纸片Kirby-Bauer法,对本院2018年全年分离的1724株临床分离株进行药物敏感性试验,应用WHONET统计软件对数据进行分析。结果:临床分离出的革兰阴性杆菌数量多于革兰阳性球菌。细菌构成比中,前3位革兰阴性杆菌分别为大肠埃希菌(19.37%)、铜绿假单胞菌(17.52%)和肺炎克雷伯菌(17.11%);革兰阳性球菌中,前3位分别为表皮葡萄球菌(5.86%)、金黄色葡萄球菌(4.41%)和屎肠球菌(3.89%)。体外药敏试验结果显示,β-溶血链球菌未见青霉素耐药菌株。对甲氧西林耐药的金黄色葡萄球菌和凝固酶阴性葡萄球菌分别为21.1%和54.45%。未发现耐万古霉素的肠球菌和葡萄球菌。大肠埃希菌对第三代头孢耐药率为52.4%,肺炎克雷伯菌为19.35%。对碳青霉烯类抗菌药物耐药的多重耐药菌菌株中,发现肺炎克雷伯菌3株,弗氏枸橼酸杆菌1株,阪崎肠杆菌1株,大肠埃希菌1株,聚团肠杆菌1株;铜绿假单胞菌34株和鲍曼不动杆菌34株。结论:定期进行耐药性监测有助于了解细菌耐药性变迁,为临床经验用药提供理论依据。

Objective:To understand the resistance of hospital clinical isolates to commonly used antibacterial drugs in 2018.Methods:Touse paper Kirby-Bauer method,1724 clinical isolates isolated in our hospital in 2018 were tested for drug sensitivity,WHONET statistical software was used to analyze the data.Results:The number of clinically isolated Gram-negative bacilli was more than Gram-positive cocci.In the bacterial composition ratio,the top three gram-negative bacilli were Escherichia coli(19.37%),pseudomonas aeruginosa(17.52%)and Klebsiella pneumoniae(17.11%).Among Gram-positive cocci,the top 3 were staphylococcus epidermidis(5.86%),staphylococcus aureus(4.41%)and enterococcus faecium(3.89%).According to the results of drug sensitivity test in vitro,no penicillin resistant strain was found inβ-Streptococcus haemolyticus.Staphylococcus aureus and coagulase-negative staphylococci that resistant to methicillin were 21.1%and 54.45%,respectively.No vancomycin-resistant enterococci and staphylococcus were found.The third generation of cephalosporin resistance of Escherichia coli was 52.4%and Klebsiella pneumoniae was 19.35%.Among multi-drug resistant strains resistant to carbapenem antibacterials,3 strains of Klebsiella pneumoniae,1 strain of citrobacter flexneri,1 strain of enterobacter sakazakii,1 strain of Escherichia coli and 1 strain of enterobacter pylori were found.34 strains of pseudomonas aeruginosa and 34 strains of acinetobacter baumannii were also found.Conclusion:Regular drug resistance monitoring is helpful to understand the changes of bacterial resistance and it can provide theoretical basis for clinical experience.