甘孜藏区某三甲医院分离细菌分布现状及对常用抗菌药物的耐药性分析

An Investigation on the Distribution of Bacteria Isolation in a Grade A Hospital in Ganzi Tibetan Prefecture and the Resistance to Antibacterial Drugs in Common Use

目的:回顾性调查甘孜藏区某三甲医院分离细菌分布现状并分析其对常用抗菌药物的耐药率。方法:选取甘孜藏区某三甲医院2017年至2020年临床分离菌株,分析标本来源、细菌检出情况、药敏结果。结果:分离非重复菌株2946株,主要来自ICU、胃肠外科、肝胆外科、创伤外科、泌尿外科;分离的病原菌中革兰阳性菌、革兰阴性菌分别占31.40%、68.60%,主要为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌;大肠埃希菌、肺炎克雷伯菌对碳青霉烯类抗菌药物高度敏感,多数菌属耐药率均<10%,金黄色葡萄球菌、表皮葡萄球菌对青霉素G耐药率最高,其次为红霉素,未检出对耐万古霉素、利奈唑胺金黄色葡萄球菌;检出超广谱β-内酰胺酶菌(ESBLs)1068株(36.25%)、耐甲氧西林葡萄球菌(MRS)159株(5.40%)、耐甲氧西林金黄色葡萄球菌(MRSA)248株(8.42%)、耐万古霉素肠球菌(VRE)2株(0.07%);MRS及MRA均对青霉素G、苯唑西林完全耐药,对万古霉素、利奈唑胺、磺胺甲噁唑/甲氧苄啶敏感。结论:甘孜藏区某三甲医院2017年至2020年分离的细菌以大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌等为主,ESBLs、MRS、MRSA、VRE均有一定检出率,且均有一定耐药性,应合理应用抗菌药物。

Objective:To investigate the distribution of bacteria isolation in a grade A hospital in Ganzi Tibetan Prefecture,and analyze the resistance to commonly used antibacterial drugs.Methods:The clinically isolated strains between 2017 and 2020 were collected and analyzed from perspectives of specimen source,detection of bacteria,and drug sensitivity test results.Results:A total of 2,946 non-repetitive strains were isolated,most of which were from ICU,department of gastrointestinal surgery,department of hepatobiliary surgery,department of neurosurgery,department of orthopedics,and department of urology.Gram-positive bacteria and gram-negative bacteria accounted for 31.40%and 68.60%,mainly including Escherichia coli,Klebsiella pneumoniae,and staphylococcus aureus.Escherichia coli and Klebsiella pneumoniae were highly sensitive to carbapenems,and the drug resistance rates of most bacteria were lower than 10%.Staphylococcus aureus and staphylococcus epidermidis were highly resistant to penicillin G,followed by erythromycin.No vancomycin or linezolid-resistant staphylococcus aureus was detected.1,068(36.25%)extended-spectrumβ-lactamase(ESBLs)strains,159(5.40%)strains of methicillin-resistant staphylococcus(MRS),and 248(8.42%)strains of methicillin-resistant staphylococcus aureus(MRSA),and 2(0.07%)strains of vancomycin-resistant enterococcus(VRE)were detected.MRS and MRA both were completely resistant to penicillin G and oxacillin,but sensitive to vancomycin,teicoplanin,linezolid,and sulfamethoxazole/trimethoprim.Conclusion:Escherichia coli,Klebsiella pneumoniae,and staphylococcus aureus were main bacteria isolated in a grade A hospitals in Ganzi Tibetan Prefecture from 2017 to 2020.ESBLs.MRS,MRSA and VRE were detected,with drug resistance.Therefore,antibacterial drugs are recommended to be used rationally.