2015年重庆医科大学附属儿童医院细菌耐药性监测

发布时间：2018-03-20 18:43

本文选题：细菌耐药监测　切入点：药物敏感性试验　出处：《中国感染与化疗杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的了解重庆医科大学附属儿童医院临床分离菌对常用抗菌药物的敏感性和耐药性。方法收集该院2015年1月1日-12月31日的临床分离菌株,采用纸片扩散法或自动化仪器法按统一方案进行细菌药物敏感性试验,按美国临床和实验室标准化协会(CLSI)2015版标准判断结果。结果共分离临床菌13 109株,其中革兰阴性菌8 560株,占65.3%,革兰阳性菌4 549株,占34.7%。金黄色葡萄球菌和凝固酶阴性葡萄球菌中甲氧西林耐药株的检出率分别为29.6%和67.1%。MRSA中有93.1%菌株对甲氧苄啶-磺胺甲唑敏感;MRCNS中有80.2%菌株对利福平敏感;未发现万古霉素、替考拉宁和利奈唑胺耐药株。肠球菌属中粪肠球菌对多数测试抗菌药物(四环素除外)的耐药率低于屎肠球菌,未检出耐万古霉素的粪肠球菌和屎肠球菌。大肠埃希菌、克雷伯菌属(肺炎克雷伯菌和产酸克雷伯菌)和奇异变形杆菌中产超广谱β内酰胺酶(ESBL)株分别为55.7%、43.5%和11.6%,产ESBL株对测试药物的耐药率均比非产ESBL株高。肠杆菌科细菌对碳青霉烯类抗生素仍高度敏感,绝大多数菌株的耐药率低于16.0%。鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别为10.5%和9.4%。与2014年相比,铜绿假单胞菌和肺炎克雷伯菌中广泛耐药菌检出率有所上升。结论细菌耐药率呈增长趋势,多重耐药和广泛耐药菌株检出率的增加对临床抗感染治疗构成严重威胁,需及时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 Children's Hospital affiliated to Chongqing Medical University. Methods Clinical isolates were collected from January 1st 2015 to December 31st in Chongqing Medical University. Bacterial susceptibility tests were carried out by disk diffusion method or automatic instrument method according to the standard of CLSI 2015 of American Association of Clinical and Laboratory Standardization. Results A total of 13 109 clinical bacteria were isolated, of which 8 560 were Gram-negative bacteria. Accounting for 65.3% of the total, 4,549 Gram-positive bacteria, The positive rates of methicillin resistant strains in Staphylococcus aureus and coagulase-negative staphylococcus were 29.6% and 67.1, respectively. 93.1% strains of MRSA were sensitive to rifampicin, 80.2% strains of MRCNS were sensitive to rifampicin, no vancomycin was found. Teicoplanin and linazolamide resistant strains. Enterococcus faecalis is less resistant to most tested antimicrobial agents (except tetracycline) than Enterococcus faecium, and vancomycin resistant Enterococcus faecalis and Enterococcus faecium have not been detected. The strains of Klebsiella pneumoniae (Klebsiella pneumoniae and Klebsiella acidogenic) and Proteus mirabilis producing extended-spectrum 尾 -lactamases (ESBLs) were 55.73.5% and 11.6B, respectively. The drug resistance rate of ESBL producing strains was higher than that of non-producing ESBL strains. Bacteria are still highly sensitive to carbapenem antibiotics, The resistance rates of Acinetobacter baumannii to imipenem and meropenem were 10.5% and 9.4 respectively. Conclusion the rate of bacterial resistance is on the increase. The increase of the detection rate of multidrug resistance and extensive drug resistance strains is a serious threat to clinical anti-infection treatment. Effective control measures should be taken in time.
【作者单位】：重庆医科大学附属儿童医院检验科儿童发育疾病研究教育部重点实验室儿科学重庆市重点实验室重庆市儿童发育重大疾病诊治与预防国际科技合作基地;
【分类号】：R446.5

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