2021年河南省某三甲医院临床分离细菌分布及耐药性监测

Distribution and drug resistance of bacteria clinically isolated in a class A tertiary hospital in Henan province in 2021

目的了解河南省某三甲医院临床标本细菌分布及其对抗菌药物的耐药性。方法收集该院2021年临床标本分离菌株,采用自动化仪器法或纸片扩散法进行药敏试验。结果共分离菌株5635株,其中革兰阳性菌2023株,占35.9%,革兰阴性菌3612株,占64.1%。分离最多的前5位细菌依次是大肠埃希氏菌、肺炎克雷伯氏菌、金黄色葡萄球菌、鲍曼不动杆菌和铜绿假单胞菌,分别占15.8%、12.1%、7.8%、7.5%和6.4%。金黄色葡萄球菌、凝固酶阴性葡萄球菌中甲氧西林耐药株(MRSA和MRCNS)的检出率分别是32.9%和79.7%;屎肠球菌对氨苄西林、左氧氟沙星和呋喃妥因的耐药率较高,分别为84.0%、80.2%和76.1%;肺炎克雷伯氏菌对碳青霉烯类的耐药率在26.8%~31.9%,肠杆菌属对厄他培南的耐药率为25.2%,其它主要肠杆菌目细菌对碳青霉烯类的耐药率均≤12.2%;铜绿假单胞菌对美罗培南和亚南培南的耐药率分别是14.6%和16.0%,鲍曼不动杆菌对二者的耐药率分别是81.6%和82.4%。结论该院2021年部分重点监测耐药菌的检出率较高,耐药形势仍然严峻,需继续加强细菌耐药监测,宜采取多种措施控制耐药菌的流行播散。

Objective To investigate the distribution and antimicrobial resistance of bacteria isolated from clinical samples in a class A tertiary hospital in Henan province.Methods clinical isolates in 2021 were collected,and antimicrobial susceptibility testing was carried out by automated systems or Kirby-Bauer method.Results A total of 5635 strains were isolated,including 2023 strains of Gram-positive bacteria(35.9%),and 3612 strains of Gram-negative bacteria(64.1%).The top five isolated bacteria were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Acinetobacter baumannii and Pseudomonas aeruginosa,accounting for 15.8%,12.1%,7.8%,7.5%and 6.4%,respectively.The detection rates of methicillin-resistant strains(MRSA and MRCNS)in Staphylococcus aureus and coagulase negative staphylococcus were 32.9%and 79.7%,respectively.The resistance rates of Enterococcus faecium to ampicillin,levofloxacin and nitrofurantoin were 84%,80.2%and 76.1%,respectively.The resistance rate of Klebsiella pneumoniae to carbapenems was 26.8%-31.9%,and Enterobacterium to ertapenem was 25.2%.The resistance rates of the other major Enterobacteriaceae to carbapenems were all≤12.2%.The resistance rates of Pseudomonas aeruginosa to meropenem and Imipenem were 14.6%and 16.0%,respectively,and the resistance rates of Acinetobacter baumannii to these two drugs were 81.6%and 82.4%,respectively.Conclusions The drugresistant rate of some key monitoring drug-resistant strains in this hospital was high in 2021,and the drug resistance situation is still severe.It is necessary to continue to strengthen the monitoring of bacterial drug resistance,and it is advised to take a variety of measures to control the spread of drug-resistant bacteria.