某医院2014-2017年临床分离病原菌种类分布及其耐药性变化分析

Analysis of distribution of clinical isolated bacteria and changes of drug resistance in 2014-2017

目的了解某医院临床分离病原菌种类分布及耐药情况,为临床合理使用抗菌药物提供科学依据。方法通过医院感染实时监控系统,对分离病原菌种类及耐药率进行回顾性分析。结果 2014-2017年共收集非重复临床分离菌株28 874株,主要病原菌种类包括大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌和肠球菌属。大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗菌药物耐药率均<5. 00%;但耐碳青霉烯类的肺炎克雷伯菌的检出率升高显著;未检出对万古霉素、替考拉宁和利奈唑胺耐药的金黄色葡萄球菌;多重耐药铜绿假单胞菌和鲍曼不动杆菌耐药形势严峻。结论该院2014-2017年细菌耐药性呈增高趋势,多重耐药菌检出率亦升高明显,应加强细菌耐药监测和规范抗菌药物的合理应用。

Objective To investigate the constitution of clinical isolated bacteria and the changes of bacterial resistance,so as to provide reference for the rational drug application in clinic. Methods By the means of the information system for real-time monitoring of nosocomial infection,the types of pathologic bacteria and drug resistance rate were analyzed. Results A total of 28 874 non-duplicate clinical strains were collected during 2014-2017. The top 6 pathogenic bacterias were Escherichia coli,Klebsiella pneumonia,Pseudomonas aeruginosa,Acinetobacter baumannii,Staphylococcus aureus and Enterococcus. The drug resistance of Escherichia coli and Klebsiella pneumoniae to Carbapenems were less than 5. 00%;but Carbapenems-resistant Klebsiella pneumoniae increased significantly. No strain of S. aureus was resistant to Vancomycin,Teicoplanin and Linezolid;the resistance rates of multiple drug resistant Pseudomonas aeruginosa and Acinetobacter baumannii were serious. Conclusion Bacterial resistance in this hospital from 2014 to 2017 takes on a rising trend. The detection rate of multiple drug-resistant bacteria also increases significantly. More attention should be paid to resistance surveillance and rational use of antibiotics.