某医疗机构2018年分离菌株耐药性监测结果分析

The drug resistance surveillance of bacterial in a hospital in 2018

目的分析医院分离主要菌株的分布特点与耐药情况,为临床合理使用抗菌药物提供参考依据。方法收集2018年临床分离的常见可致病菌株5916株,使用VITEK-2 Compact系统进行细菌鉴定,采用MIC法和K-B纸片扩散法进行药敏试验,采用WHONET 5.6软件对数据进行统计分析。结果5916株菌株标本主要来源于尿液、痰液、分泌物和血液。其中,革兰阴性菌占66.9%,主要为大肠埃希菌;革兰阳性菌占20.4%,主要为金黄色葡萄球菌。革兰阴性菌如大肠埃希菌、肺炎克雷伯菌对氨苄西林耐药率最高(分别为82.8%和71.2%),对碳青霉烯类药物的耐药率分别为1.9%、16.5%。革兰阳性菌如金黄色葡萄球菌、表皮葡萄球菌对青霉素G的耐药率最高(分别为92.2%和93.9%),对利奈唑胺、万古霉素、替加环素的耐药率均为0%。鲍曼不动杆菌对亚胺培南、美洛培南的耐药率分别为53.5%、50.3%。铜绿假单胞菌对亚胺培南、美洛培南的耐药率分别为13.2%、8.7%。结论2018年某医院临床耐药菌株种类较多,医务人员应严格落实感控措施,合理使用抗菌药物。

Objective To analyze the distribution characteristics and the antimicrobial resistance of main isolates in a hospital,so as to provide the reference for reasonable use of antibacterial drugs in clinical departments.Methods A total of 5916 strains of common pathogenic bacteria were collected from clinical isolates in 2018.VITEK-2 compact system was used for bacterial identification,Mic method and K-B disk diffusion method were used for drug sensitivity test.WHONET 5.6 software was used for statistical analysis of the data.Results The specimens of 5916 strains were main originated from urine,sputum,secretions,and blood.The Gram-negative bacteria accounted for 66.9%,which mainly includes Escherichia coli.The Gram-positive bacteria accounted for 20.4%,which mainly includes Staphylococcus aureus.The Gram-negative bacteria such as Escherichia coli and Klebsiella pneumoniae have the highest resistance rates to ampicillin(82.8%and 71.2%respectively),and their resistance rates to carbapenems are 1.9%and 16.5%respectively.The Gram-positive bacteria such as Staphylococcus aureus and Staphylococcus epidermidis have the highest resistance rates to penicillin G(92.2%and 93.9%respectively),and their resistance rates to linezolid,vancomycin,and tigecycline are 0%.The resistance rates of Acinetobacter baumannii to imipenem and meropenem were 53.5%and 50.3%respectively.The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 13.2%and 8.7%respectively.Conclusions There are many types of drug-resistant strains isolated from clinical in a hospital in 2018.Medical staffs should strictly implement the control measures of infection,and reasonably use antibacterial drugs.