2014年临床常见分离菌耐药特性分析

发布时间：2018-06-07 10:17

本文选题：耐药性监测 + 抗菌药物　；参考：《中国抗生素杂志》2016年05期

【摘要】：目的了解南昌大学第二附属医院2014年临床分离菌对常用抗菌药物的敏感性和耐药性。方法收集我院2014年1月1日至12月31日非重复临床分离株,采用纸片扩散法或自动化仪器法进行药物敏感性试验。按美国临床实验室标准化协会(CLSI)2014年版标准判断结果,WHONET 5.5软件进行耐药性分析。结果共收集非重复临床分离菌4034株,其中革兰阳性菌1263株,占31.3%,革兰阴性菌2771株,占68.7%。耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(methicillin-resistant coagulase-negative Staphylococcus,MRCNS)检出率分别为25.8%和79.9%。未发现利奈唑胺和万古霉素耐药株。90.4%MRSA对复方磺胺甲VA唑敏感,80.3%MRCNS对利福平敏感。粪肠球菌对绝大多数抗菌药物的耐药率显著低于屎肠球菌,未发现对利奈唑胺耐药株,检出3株万古霉素耐药屎肠球菌。肺炎链球菌青霉素耐药株检出率为21.2%,较去年有所增长。产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和克雷伯菌属(肺炎克雷伯菌,产酸克雷伯菌)分别为58.5%和27.4%。铜绿假单胞菌对亚胺培南耐药率为16.5%,鲍曼不动杆菌对亚胺培南耐药率为63.3%。多重耐药鲍曼不动杆菌检出率为69.4%,较去年略有下降。肠杆菌科细菌中有小部分碳青霉烯类抗生素耐药株,较去年相比呈较大幅度上升趋势,仍以肺炎克雷伯菌为主。结论细菌耐药性仍呈增长趋势,尤以耐碳青霉烯类抗生素肠杆菌科细菌为重,多重耐药和广泛耐药株在某些病区的流行播散对临床构成严重威胁,应进行流行病学调查并采取有效的感控措施。
[Abstract]:Objective to investigate the susceptibility and drug resistance of clinical isolates to common antimicrobial agents in the second affiliated Hospital of Nanchang University in 2014. Methods Non-repeated clinical isolates were collected from January 1 to December 31, 2014, and drug sensitivity tests were performed by disk diffusion or automatic instrument method. Drug resistance was analyzed by software WHONET 5.5 according to the 2014 edition of the American Association of Clinical Laboratory Standardization (CLSI). Results A total of 4034 non-repeated clinical isolates were collected, of which 1263 were Gram-positive bacteria (31.3%) and 2771 Gram-negative bacteria (68.7%). The detection rates of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococcus aureus were 25.8% and 79.9%, respectively. No linazolamide and vancomycin resistant strain. 90.4 MRSA was sensitive to compound sulfamethazolium 80.3% MRCNS was sensitive to rifampicin. The resistance rate of Enterococcus faecalis to most antimicrobial agents was significantly lower than that of Enterococcus faecium, and three strains of vancomycin resistant Enterococcus faecalis were not found to be resistant to linazolamide. The detection rate of penicillin-resistant strains of Streptococcus pneumoniae was 21. 2%, which was higher than that of last year. The rates of Escherichia coli and Klebsiella (Klebsiella pneumoniae) producing extended-spectrum 尾 -lactamases (ESBLs) were 58.5% and 27.4%, respectively. The resistance rate of Pseudomonas aeruginosa to imipenem was 16.5 and that of Acinetobacter baumannii to imipenem was 63.3. The detection rate of multi-resistant Acinetobacter baumannii was 69. 4%, slightly lower than last year. A small number of carbapenem antibiotic resistant strains were found in Enterobacteriaceae. Compared with last year, Klebsiella pneumoniae is still the main bacteria. Conclusion the drug resistance of bacteria is still on the increase, especially those of Enterobacteriaceae, a carbapenem resistant antibiotic. The prevalence of multidrug resistance and widespread drug resistance in some areas is a serious threat to clinical practice. Epidemiological investigation should be carried out and effective control measures should be taken.
【作者单位】：南昌大学第二附属医院;
【分类号】：R446.5

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