贵州某医院2014—2019年老年患者临床分离菌的分布特点和耐药性分析

Distribution Characteristics and Antibiotic Resistance Analysis of the Bacterial Strains Isolated from Elderly Patients in a Hospital in Guizhou from 2014 to 2019

目的了解2014—2019年贵州某医院老年患者临床分离菌的分布特点及对抗生素的耐药性。方法采用phixone;100鉴定系统进行细菌鉴定,Kirby-Bauer纸片扩散法和全自动仪器进行药敏试验,按照美国临床和实验室标准化协会(CLSI)2019年标准判断结果。结果收集到老年患者临床分离菌12903株,其中革兰阳性菌占22.7%,革兰阴性菌占77.3%。呼吸道标本是病原菌的主要来源,占53.3%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率为38.7%、85.9%。青霉素耐药肺炎链球菌(PRSP)检出率为9.2%。肺炎克雷伯菌和铜绿假单胞菌对亚胺培南的耐药率分别为10.7%、20.4%,对美罗培南的耐药率分别为10.4%和13.8%,鲍曼不动杆菌对亚胺培南和美罗培南的耐药率均达到61.0%。结论通过对老年患者临床分离菌的分布特点和耐药性进行分析,对促进老年患者个体化抗感染治疗和遏制细菌耐药蔓延具有重要指导意义。

Objective Analyze the distribution characteristics and antibiotic resistance of bacterial strains isolated from elderly patients in a Hospital in Guizhou from 2014 to 2019.Methods Phoenix100 identification system was used for bacterial identification,Kirby Bauer disc diffusion method and automatic instrument for drug sensitivity test.Results were analyzed according to the Clinical and Laboratory Standards Institute(CLSI)2019 standards.Results A total of 12,903 clinical isolates were collected from elderly patients,of which 22.7%were Gram-positive and 77.3%were Gram-negative.Respiratory tract specimens were the main source of pathogenic bacteria,accounting for 53.3%.The detection rates of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus(MRCNS)were 38.7%and 85.9%.The detection rate of penicillin-resistant Streptococcus pneumoniae(PRSP)was 9.2%.The resistance rates of Klebsiella pneumoniae and Pseudomonas aeruginosa to imipenem were 10.7%and 20.4%,respectively,and the resistance rates to meropenem were 10.4%and 13.8%,respectively.The drug resistance rate of Acinetobacter baumannii to imipenem and meropenem reached 61.0%.Conclusions By analyzing the distribution characteristics and drug resistance of clinical isolates from elderly patients,it is of great guiding significance to promote the individualized anti-infective treatment of elderly patients and curb the spread of bacterial resistance.