分析河南省传染病医院2015-2020年间临床分离菌分布及耐药性变迁

Distribution and Drug Resistance of Clinical Isolates in Henan Infectious Disease Hospital From 2015 To 2020

目的了解河南省传染病医院2015—2020年临床常见分离菌的分布情况及耐药性变迁,为临床合理用药提供依据。方法使用VITEK 2 Compact全自动细菌鉴定仪进行细菌鉴定,采用VITEK 2 Compact和K-B法进行抗菌药物敏感性试验。结果河南省传染病医院2015—2020年共分离临床菌株4940株,其中革兰阴性菌3438株,占69.6%;革兰阳性菌1502株,占30.4%。6年间肺炎克雷伯菌所占比例不断上升。碳青霉烯类耐药的菌株中,肺炎克雷伯菌检出率不断升高,大肠埃希菌检出率仍维持在较低的水平。耐甲氧西林金黄色葡萄球菌(MRSA)与耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)6年内平均检出率分别为36.2%和55.8%。结论6年间本院碳青霉烯类耐药的肺炎克雷伯菌检出率明显增加,耐药形势严峻,应加强耐药监测和抗菌药物临床应用管理,实施有效的防控措施,防止耐药菌的流行和传播。

Objective To understand the distribution and drug resistance changes of common clinical isolates in Henan infectious disease hospital from 2015 to 2020,and provide basis for clinical rational drug use.Methods VITEK 2 Compact automatic bacterial identification and susceptibility analysis system and Vitek MS mass spectrometer were used for bacterial identification.VITEK 2 Compact and K-B methods were used for antimicrobial susceptibility test.Results A total of 4940 clinical strains were isolated in our hospital from 2015 to 2020,including 3438 strains Gram-negative bacteria,accounting for 69.6%,1502 strains Gram-positive bacteria,accounting for 30.4%.The proportion of Klebsiella pneumoniae rose continuously over the past six years.The detection rate of carbapenem resistant Klebsiella pneumoniae increased,and the detection rate of carbapenem resistant Escherichia coli remained at a low level.The average detection rate of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus cocci(MRCNS)was 36.2%and 55.8%,respectively.Conclusion The detection rate of carbapenem resistant Klebsiella pneumoniae in our hospital has increased significantly in the past 6 years,and the drug resistance situation is grim.We should strengthen the drug resistance monitoring and clinical application management of antibiotics,and implement effective prevention and control measures to prevent the prevalence and spread of drug-resistant bacteria.