某院患者分离病原菌的分布及耐药性监测

Distribution and Drug Resistance Monitoring of Isolated Pathogenic Bacteria in Hospital

目的了解医院患者临床分离病原菌流行分布特征及耐药变化趋势,指导临床合理用药。方法收集医院2020年1月至12月收治患者分离的非重复病原菌984株,采用法国生物梅里埃公司VITEK2自动鉴定药敏仪进行细菌鉴定和药物敏感性试验,用WHONET5.6版软件对数据进行统计与分析。结果分离的984株病原菌中,革兰阴性菌795株(80.8%),以大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌为主;革兰阳性菌189株(19.2%),以葡萄球菌属和肠球菌属为主,耐甲氧西林金黄色葡萄球菌、耐甲氧西林表皮葡萄球菌检出率分别为11.17%,65.63%。葡萄球菌属未发现对万古霉素、替考拉宁和利奈唑胺耐药的菌株;大肠埃希菌、肺炎克雷伯菌对哌拉西林/他唑巴坦的耐药率低于5.0%。结论细菌对抗菌药物的耐药性在不断变化,需采取有效的医院感染预防控制措施,以规范和控制抗菌药物的使用。

Objective To understand the epidemic distribution characteristics and drug resistance trend of clinical isolated pathogenic bacteria of patients in hospital,and guide clinical rational drug use.Methods A total of 984 strains of non-repetitive pathogenic bacteria isolated from patients were collected in hospital from January to December 2020.Bacterial identification and drug sensitivity tests were carried out with VITEK2 automatic identification drug sensitivity instrument of Bio Mérieux,then the data of tests were counted and analyzed with WHONET software(version 5.6).Results Among 984 strains of isolated pathogenic bacteria,795 strains(80.8%)of Gram-negative bacteria included,which mainly including Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Pseudomonas aeruginosa.A total of 189 strains of Gram-positive bacteria(19.2%)included,mainly including Staphylococcus and Enterococcus,the detection rates of Methicillin-resistant Staphylococcus aureus(MRSA)and Methicillin-resistance Staphylococcus epidermidis(MRSE)were 11.17%and 65.63%.The strain no resistance to vancomycin,teicoplanin and linezolid was not found in Staphylococcus epidermidis.The resistance rate of Escherichia coli and Klebsiella pneumoniae to piperacillin/tazobactam was lower than 5.0%.Conclusion The resistance of bacteria to antimicrobial drugs is changing constantly,so effective measures for prevention and control of hospital infection should be taken to standardize and control the use of antimicrobial drugs.