四川省细菌耐药监测网2015年四川省细菌耐药性监测结果分析

发布时间：2018-03-19 18:53

本文选题：细菌耐药性监测　切入点：耐药率　出处：《中国抗生素杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的统计分析四川省细菌耐药监测网成员单位2015年度病原菌分布及耐药情况,为我省抗菌药物合理应用提供依据。方法按照监测方案,采用标准纸片扩散法或自动化仪器检测法,测定监测药物对细菌的敏感性,依据CLSI 2015年标准,使用WHONET 5.6软件进行数据统计分析。结果 74家医院参加了2015年度细菌耐药监测工作,其中数据合格纳入分析的共68家,按患者首次分离菌株进行统计分析,共纳入细菌143475株,其中革兰阴性菌104216株(72.6%),革兰阳性菌39259株(27.4%)。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28.2%和70.9%,未发现对万古霉素、利奈唑胺和替考拉宁耐药的菌株。粪肠球菌和屎肠球菌对万古霉素和利奈唑胺的耐药率分别为0.9%和4.4%,1.0%和0.8%。非脑脊液标本分离的肺炎链球菌对青霉素耐率为1.5%,对红霉素耐药率为91.5%。革兰阴性菌中分离率排前3位的是大肠埃希菌31763株(30.5%)、肺炎克雷伯菌19921株(19.1%)和铜绿假单胞菌12846株(12.3%)。大肠埃希菌对头孢曲松、头孢噻肟耐药率在55.0%以上,对喹诺酮类耐药率接近50%;肺炎克雷伯菌对第三代头孢菌素耐药率低于40.0%,对喹诺酮类药物耐药率低于15.0%;耐碳青霉烯的大肠埃希菌和肺炎克雷伯菌检出率分别为2.0%和3.1%。铜绿假单胞菌对多黏菌素B耐药率低于1.0%,耐碳青霉烯的铜绿假单胞菌检出率为15.7%;鲍曼不动杆菌对包括碳青霉烯类的大多数药物耐药率均在50.0%以上。结论我省细菌耐药情况同以往比较,MRSA呈下降趋势,而耐碳青霉烯类的肠杆菌科细菌、耐万古霉素的肠球菌与广泛耐药的非发酵菌仍呈增长趋势,长期监测有助于了解本地细菌耐药性变迁情况,为临床合理用药提供依据。
[Abstract]:Objective to analyze the distribution of pathogenic bacteria and drug resistance in Sichuan Province in 2015, so as to provide the basis for rational use of antimicrobial agents in Sichuan Province. The susceptibility of drugs to bacteria was determined by standard disk diffusion method or automatic instrument test, according to CLSI 2015 standard. Results 74 hospitals participated in the surveillance of bacterial drug resistance in 2015, of which 68 were qualified to be included in the analysis. According to the statistical analysis of the first isolated strains of the patients, 143475 strains of bacteria were included. The detection rates of Gram-negative bacteria (104216 strains), Gram-positive bacteria (39259 strains), methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MRCNS) were 28.2% and 70.9, respectively. No vancomycin was found. The resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin and linazolamide were 0.9% and 4.4%, respectively. The resistance rate of Streptococcus pneumoniae isolated from non-cerebrospinal fluid samples to penicillin was 1.5 and to red. Among Gram-negative bacteria, 31763 strains of Escherichia coli and 19921 strains of Klebsiella pneumoniae were found to have the highest resistance to mycin, and 12846 strains of Pseudomonas aeruginosa were found to be Ceftriaxone. The resistance rate of cefotaxime was more than 55.0%. The resistance rates of Klebsiella pneumoniae to the third generation cephalosporins and quinolones were lower than 40.0 and 15.0 respectively, and the detection rates of carbapene-resistant Escherichia coli and Klebsiella pneumoniae were 2.0% and 15.0, respectively. 3.1.The resistance rate of Pseudomonas aeruginosa to polymyxin B was lower than 1.0, and the detection rate of carbapene-resistant Pseudomonas aeruginosa was 15.7.The resistance rate of Acinetobacter baumannii to most drugs, including carbapenem, was more than 50.0%. Conclusion the drug resistance rate of Acinetobacter baumannii is more than 50.0%. Compared with the past, the drug resistance of bacteria showed a decreasing trend. However, enterobacteriaceae, vancomycin resistant Enterococcus and extensively resistant non-fermentative bacteria still showed an increasing trend, and long-term monitoring was helpful to understand the changes of drug resistance of local bacteria and to provide evidence for clinical rational use of drugs.
【作者单位】：四川省医学科学院四川省人民医院检验科;
【分类号】：R446.5

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