2015-2016年河北医科大学第二医院细菌耐药性监测

发布时间：2018-04-27 12:02

本文选题：病原菌 + 抗菌药物　；参考：《中国感染与化疗杂志》2017年06期

【摘要】：目的了解2015-2016年河北医科大学第二医院临床分离病原菌耐药情况。方法共收集16 292株非重复临床分离菌,采用VITEK 2-Compact进行细菌鉴定,采用自动化仪器法结合纸片扩散法进行药敏试验,使用WHONET 5.6软件进行数据统计分析。结果 2015、2016年分别收集临床分离菌7 961株、8 331株,革兰阴性菌分别占62.0%、66.9%。2年分离前5位的细菌是肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌和金黄色葡萄球菌,2016年肺炎克雷伯菌分离率上升至第1位(16.1%),血标本凝固酶阴性葡萄球菌分离率由2015年42.6%降至30.0%,葡萄球菌中未发现万古霉素耐药株。2年耐甲氧西林金黄色葡萄球菌(MRSA)检出率分别为56.2%、51.3%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)为79.3%、63.1%。911株肠球菌属细菌中粪肠球菌和屎肠球菌分别占25.2%和73.2%。2年屎肠球菌对万古霉素耐药率分别为3.1%、2.9%,2016年肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌对碳青霉烯类耐药率持续上升,肺炎克雷伯菌对除庆大霉素、阿米卡星外所有选择抗菌药物耐药率均呈现上升趋势,对亚胺培南、美罗培南耐药率分别由2015年19.3%、18.5%上升至2016年24.2%、23.1%。2年间鲍曼不动杆菌对常规选择抗菌药物依然维持较高的耐药性,除多黏菌素B、替加环素、头孢哌酮-舒巴坦、米诺环素外,对其他受试抗菌药物耐药率均高于50%。铜绿假单胞菌对阿米卡星、头孢哌酮-舒巴坦,哌拉西林-他唑巴坦、头孢他啶、头孢吡肟耐药率相对较低,分别为11.7%、15.5%、18.7%、20.1%、21.9%。2年间铜绿假单胞菌除对氨曲南耐药率由2015年27.0%上升到2016年34.7%外,对其他抗菌药物耐药率均出现了下降趋势。结论细菌对抗菌药物的耐药性在不断变化,需采取有效的医院感染防控措施,进一步规范控制抗菌药物使用。
[Abstract]:Objective to investigate the drug resistance of pathogenic bacteria isolated from the second Hospital of Hebei Medical University from 2015 to 2016. Methods A total of 16 292 strains of non-repeated clinical isolates were collected and identified by VITEK 2-Compact. The drug sensitivity test was performed by automatic instrument method combined with disk diffusion method, and the data were statistically analyzed by WHONET 5.6 software. Results among the 7 961 strains of clinical isolates collected in 2015 and 2016, 8 331 were Gram-negative bacteria, and the top 5 bacteria isolated in 66.9.2 years were Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumannii, respectively, and the results showed that the most important bacteria were Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumannii. Pseudomonas aeruginosa and Staphylococcus aureus, the isolation rate of Klebsiella pneumoniae increased to 16.1% in 2016, the isolation rate of coagulase-negative staphylococci in blood samples decreased from 42.6% in 2015 to 30.0%, and vancomycin resistant strain .2 was not found in Staphylococcus. The annual MRSAs of methicillin-resistant Staphylococcus aureus were 56.2% and 51.3%, respectively. The MRCNS of methicillin-resistant coagulase negative staphylococci were 79.3% and 63.1%, respectively. Among the 911 strains of Enterococcus, Enterococcus faecium and Enterococcus faecium accounted for 25.2% and 73.2.2% of Enterococcus faecium and Enterococcus faecium respectively. The drug resistance rates were 3.1% and 2.9%, respectively. In 2016, Klebsiella pneumoniae, The resistance rate of Escherichia coli to carbapenem and Klebsiella pneumoniae to all the antimicrobial agents except gentamicin and amikacin showed an increasing trend, and to imipenem, the resistance rate of Escherichia coli to carbapenem was increasing, and the resistance rate of Klebsiella pneumoniae to all antimicrobial agents except gentamicin and amikacin showed an increasing trend. The resistance rate of meropenem increased from 19.3g / 18.5% in 2015 to 24.2% in 2016, respectively. During the period of 23.1.2 years, Acinetobacter baumannii remained high resistance to conventional antimicrobial agents, except polymyxin B, tegacyclin, cefoperazone-sulbactam, minocycline. The rate of resistance to other antimicrobial agents was higher than that of 50%. The resistance rates of Pseudomonas aeruginosa to amikacin, cefoperazone-sulbactam, piperacillin-tazobactam, ceftazidime and cefepime were relatively low. The resistance rate of Pseudomonas aeruginosa to aztreonam increased from 27.0% in 2015 to 34.7% in 2016. Conclusion the antimicrobial resistance of bacteria is constantly changing, it is necessary to take effective measures to prevent and control nosocomial infection and to regulate the use of antimicrobial agents.
【作者单位】：河北医科大学第二医院检验科;河北医科大学;
【基金】：河北省科技厅指导性计划(152777238)
【分类号】：R446.5

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