宁夏细菌耐药监测网2015年细菌耐药监测数据分析

发布时间：2018-01-01 11:21

本文关键词：宁夏细菌耐药监测网2015年细菌耐药监测数据分析　出处：《中国抗生素杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的对宁夏细菌耐药监测网成员单位2015年度临床分离细菌分布及耐药情况进行统计分析,为本省临床合理使用抗菌药物提供理论依据。方法各成员单位临床分离菌株,采用标准纸片扩散法或自动化仪器检测法,按照统一技术方案测定监测药物对细菌的敏感性,依据CLSI 2014年标准,用WHONET 5.6软件进行数据分析。结果共有30家医院参加了2015年度细菌耐药监测工作,其中数据基本合格纳入分析的共20家。按患者首次分离菌株进行统计分析,共收集细菌25234株,其中革兰阴性菌18412株(72.97%),革兰阳性菌6822株(27.03%)。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为38.6%和77.3%,未发现万古霉素和利奈唑胺不敏感的葡萄球菌。万古霉素耐药粪肠球菌和屎肠球菌分别为1.7%和1.2%。按非颅内感染的折点判断,耐青霉素肺炎链球菌比例为8%。革兰阴性菌中分离率前3位分别为大肠埃希菌、肺炎克雷伯菌和鲍曼不动杆菌,分别为5469株(21.67%)、4609株(18.26%)和1843株(7.3%)。大肠埃希菌耐药比较突出,对喹诺酮类耐药率在50.0%以上,肠杆菌科细菌对碳青霉烯类抗菌药物总耐药率低于10.0%。铜绿假单胞菌对碳青霉烯类、氨基糖苷类、哌拉西林/三唑巴坦、头孢吡肟、头孢哌酮/舒巴坦和头孢他啶的耐药率低于15.0%,鲍曼不动杆菌对包括碳青霉烯类在内的大多数监测药物耐药率超过50.0%,亚胺培南的耐药率为65%。结论我省细菌耐药整体较全国水平较低,但多重耐药和广泛耐药菌株检出仍对临床治疗造成严重威胁,应充分利用本地细菌耐药监测结果进行感控管理,促进抗菌药物合理使用。
[Abstract]:Objective to carry on the statistical analysis of Ningxia bacterial resistance monitoring network of member units in 2015 clinical isolates of bacteria distribution and drug resistance, for the clinical rational use of antimicrobial drugs provide theoretical basis. All members of the clinical isolates, using standard disk diffusion method or instrument automatic detection, monitoring of bacterial drug sensitivity determination in accordance with the unified technology plan, according to the CLSI standard in 2014, data were analyzed by WHONET 5.6 software. Results a total of 30 hospitals participated in the 2015 annual bacterial resistance monitoring, the basic data pass into the analysis of total 20. Statistical analysis was carried out according to the patient's first isolated strains, 25234 strains of bacteria were collected, including 18412 strains of gram negative bacteria (72.97%), 6822 strains of gram positive bacteria (27.03%). Methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative staphylococcus (MRCNS). Detection rates were 38.6% and 77.3%, is not sensitive to vancomycin and linezolid vancomycin resistant Staphylococcus aureus was found. Enterococcus faecalis and Enterococcus faecium were 1.7% and 1.2%. at the break point non intracranial infection, penicillin resistant Streptococcus pneumoniae ratio of 8%. gram negative bacteria isolation rate of the top 3 were Escherichia coli, Klebsiella pneumoniae and Bauman Acinetobacter, respectively, 5469 strains (21.67%), 4609 strains (18.26%) and 1843 strains (7.3%). The resistance of Escherichia coli is more prominent, the quinolone resistance rate in 50% above, Enterobacteriaceae antimicrobial resistance rate of less than 10.0%. of Pseudomonas aeruginosa on carbon carbapenem susceptible to carbapenems, aminoglycosides, piperacillin / tazobactam three, cefepime, Cefoperazone / Shubatan and ceftazidime resistance rate of less than 15%, Bauman Acinetobacter most of the prison including carbapenems Measurement of the drug resistance rate of more than 50%, imipenem resistance was 65%. conclusion the bacterial resistance is lower than the national overall level is low, but the detection of multidrug resistant and extensively drug-resistant strains still pose a serious threat to the clinical treatment, should make full use of the monitoring results of bacterial resistance to local infection control management, and promote the rational use of antibiotics.

【作者单位】：宁夏医科大学总医院医学实验中心;宁夏临床病原微生物重点实验室;
【基金】：宁夏医科大学校级项目(No.XM2015095)
【分类号】：R446.5
【正文快照】： 近年来,随着抗菌药物在临床的广泛应用,耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcusaureus,MRSA)、耐万古霉素肠球菌(vancomycin resistantEnterococcus,VRE)、耐碳青霉烯类肠杆菌科细菌(carbapenem-resistant Enterobacteriaceae,CRE)、多重耐药鲍曼不动

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