上海市松江区2018年-2019年间5家综合性医院不发酵糖革兰阴性杆菌的分布及其耐药性分析

Analysis on Distribution and Resistance of Non-fermentative Gram-negative Bacilli in 5 General Hospitals in Songjiang District of Shanghai from 2018 to 2019

目的:分析上海市松江地区2018年—2019年间5家综合性医院不发酵糖革兰阴性杆菌的分布及其耐药情况,为本区域抗菌药物的合理使用提供参考。方法:收集2018年1月1日—2019年12月31日间松江地区5家综合性医院各类标本,统计其各不发酵糖革兰阴性杆菌(其中铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌、洋葱伯克霍尔德菌和其他菌株)的临床分布特点与标本的来源,分析其不发酵糖革兰阴性杆菌中各菌株的分布特点及其对不同抗菌药物的耐药情况。结果:2年间临床分离出不发酵糖革兰阴性杆菌1 364株,其构成比从高至低依次为铜绿假单胞菌(42.52%)、鲍曼不动杆菌(36.22%)、嗜麦芽窄食单胞菌(5.13%)和洋葱伯克霍尔德菌(2.57%)等;药敏结果发现,铜绿假单胞菌对复方磺胺甲噁唑、氨苄西林-舒巴坦钠的耐药率均高于75.00%,对美罗培南、亚胺培南的耐药率分别为9.83%和8.79%;鲍曼不动杆菌对替加环素的耐药率小于5.00%,对美罗培南和亚胺培南的耐药率分别为39.27%和37.45%,对庆大霉素和阿米卡星的耐药率分别为30.97%和30.36%,对米诺环素的耐药率为9.72%。结论:5家综合性医院中临床不发酵糖革兰阴性杆菌感染情况不容小觑,应加强对医疗器械的日常规范消毒、细菌的耐药性监测及医院感染防控,遏制其病原菌的耐药和减少院内感染的发生。

Objective: To analyze the distribution and drug resistance of Non-fermentative Gram-negative Bacilli(NFGNB) in 5 general hospitals in Songjiang District of Shanghai from 2018 to 2019, and to provide reference for rational usage of antibacterials in this District. Methods: All kinds of specimens collected from 5 general hospitals in Songjiang District from January 1, 2018 to December 31, 2019 were collected. The clinical distribution characteristics and the source of samples of NFGNB(including Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, Burkholderia cepacia and other strains) were summarized. The distribution characteristics of the NFGNB and their resistance to different antibacterials were analyzed. Results: During the two years, 1 364 strains of NFGNB were clinically isolated, and the component ratio of them from high to low was Pseudomonas aeruginosa(42.52%), Acinetobacter baumannii(36.22%), Stenotrophomonas maltophila(5.13%) and Burkholderia cepacia(2.57%). The drug susceptibility results showed that the drug resistance rates of Pseudomonas aeruginosa to cotrimoxazole and ampicillin sulbactam sodium were higher than 75%, and the drug resistance rates to meropenem and imipenem were 9.83% and 8.79%,respectively. The drug resistance rates of Acinetobacter baumannii to tigecycline were less than 5%, to meropenem and imipenem were 39.27% and 37.45%, respectively, to gentamicin and amicacin were 30.97% and 30.36%, respectively,and to minocycline were 9.72%. Conclusion: Five comprehensive hospitals clinical NFGNB infection to be reckoned with, and to strengthen the routines of medical apparatus and instruments had to disinfected, bacterial drug resistance surveillance and hospital infection prevention and control measures, curbing its pathogenic bacteria resistance and reduced the occurrence of nosocomial infection.