广西某医院2016年―2020年临床分离主要革兰阴性杆菌的耐药监测

Resistance Surveillance of Major Gram-negative Bacilli Isolated from a Hospital of Guangxi from 2016 to 2020*1

目的:分析医院临床分离的主要革兰阴性杆菌的耐药性和耐药趋势,为临床合理使用抗菌药物提供参考。方法:收集2016年―2020年医院临床送检的微生物培养数据资料,分析主要革兰阴性杆菌的耐药性和耐药趋势。结果:2016年-2020年,共检出革兰阴性杆菌10 456株,其中前5位的依次为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和阴沟肠杆菌;药敏结果显示,大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌对亚胺培南、美罗培南、哌拉西林-他唑巴坦钠和阿米卡星的耐药率较低;铜绿假单胞菌对多黏菌素B和多黏菌素E的耐药率均为0.00%,对亚胺培南、美罗培南耐药率较低,但呈逐年上升趋势;鲍曼不动杆菌仅对多黏菌素B和多黏菌素E高度敏感。结论:革兰阴性杆菌对抗菌药物的耐药率整体较为平稳,但铜绿假单胞菌和鲍曼不动杆菌对亚胺培南和美罗培南的耐药率呈上升趋势,医院应完善病原学检查和耐药监测,以促进抗菌药物的合理使用,遏制耐药菌株的流行。

Objective: To analyze the drug resistance and its trend of major Gram-negative bacilli isolated from a hospital so as to provide reference for rational use of antibacterials in clinic. Methods: The data of microbial culture from2016 to 2020 were collected to analyze the drug resistance and its trend of major Gram-negative bacilli. Results: A total of10 456 strains of Gram-negative bacilli were detected from 2016 to 2020, among which the top 5 were Escherichia coli,Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacter cloacae. The results of drug susceptible test showed that Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae were highly sensitive to imipenem, meropenem, piperacillin-tazobactam and amikacin. The resistance rates of Pseudomonas aeruginosa to polymyxins B and E were 0.00%, and the resistance rates to imipenem and meropenem were low but showed a increasing trend. Acinetobacter baumannii was only highly sensitive to polymyxins B and E. Conclusion: The resistance rates of Gram-negative bacilli to antibacterials are stable, but the resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem and meropenem show an increasing trend. Etiological examination and resistance surveillance should be strengthened to promote rational use of antibacterials and reduce the development of drug resistance strains.