酒泉市细菌耐药性监测

Bacterial Resistance Monitoring in Jiuquan City

目的了解2017—2018年酒泉市临床分离细菌对常用抗菌药物的敏感性和耐药性,为临床合理使用抗菌药物提供依据。方法收集酒泉市四家全国细菌耐药监测网成员单位2017—2018年的临床分离菌株,采用自动化仪器法或纸片扩散法(K-B法)进行细菌药物敏感性试验,按照美国临床实验室标准化研究所(CLSI)2017年版标准判断结果,使用WHONET 5.6软件统计分析。结果共分离细菌4146株,其中革兰阳性菌698株,占16.8%,革兰阴性菌3448株,占83.2%。金黄色葡萄球菌和凝固酶阴性葡萄球菌中甲氧西林耐药株的(MRSA和MRCNS)检出率分别为23.6%和57.1%,未发现万古霉素、替考拉宁和利奈唑胺耐药菌株。未发现万古霉素和替考拉宁耐药的肠球菌。肠杆菌科细菌对碳青霉烯类抗生素敏感性高,对阿米卡星的耐药率低,大肠埃希菌对头孢噻肟的耐药率达45.1%,对头孢他啶的耐药率为18.0%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为12.1%和12.6%。鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别为31.9%和27.6%。结论酒泉市细菌耐药性较全国偏低,但临床分离细菌已对多种药物产生了不同程度的耐药性,耐药趋势不容忽视,医院应加强抗菌药物合理应用及院内感染防控措施,同时微生物实验室应加强细菌耐药监测工作,及时向临床通报监测数据,全面有效遏制耐药菌流行。

Objective To understand the sensitivity and drug resistance of clinical isolates of Jiuquan city from 2017 to 2018 to common antimicrobial agents.Methods Clinical isolates from 2017-2018 from four member units of the National Bacterial resistance Monitoring network in Jiuquan city were collected,and bacterial drug sensitivity tests were conducted using automated instrument method or disk diffusion method(K-B method).The results were judged according to the 2017 version of CLSI standards,and statistical analysis was performed using WHONET 5.6 software.Results A total of 4146 strains of bacteria were isolated,among which 698 strains were gram-positive,accounting for 16.8%,and 3448 strains were gram-negative,accounting for 83.2%.The detection rates of MRSA and MRCNS in Staphylococcus aureus and Coagulase-negative Staphylococcus aureus were 23.6%and 57.1%,respectively.There were no virulent,suteicoranin and Linezolid resistant strains.Vancomycin and teikoranin-resistant enterococcus were not found.The enterobacteriaceae bacteria were highly sensitive to carbapenems antibiotics and had low drug resistance rate to amikacin.The drug resistance rate of Escherichia coli to cefotaxime and ceftazidime was up to 45.1%and 18.0%respectively.The drug resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 12.1%and 12.6%,respectively.The drug resistance rates of acinetobacter baumannii to imipenem and perenem were 31.9%and 27.6%,respectively.Conclusion Drug Resistance of bacteria in Jiuquan is lower than that in the whole country.However,in clinical isolation,bacteria have developed different levels of drug resistance to many kinds of drugs,and the trend of drug resistance can not be ignored.The hospital should strengthen the rational use of antibiotics and the prevention and control of nosocomial infection.At the same time,the microbiology laboratory should strengthen the monitoring of bacterial drug resistance,timely inform the clinical monitoring data,and comprehensively and effectively curb the prevalence of drug-resistant bacteria.