2015年宁波市某二级医院细菌耐药性监测

发布时间：2018-05-30 00:21

本文选题：抗菌药物 + 细菌耐药性监测　；参考：《中国抗生素杂志》2017年01期

【摘要】：目的了解宁波市镇海龙赛医院2015年临床分离细菌分布和耐药特征,为临床合理选择抗菌药物提供依据。方法收集临床分离的1083株非重复细菌,采用纸片扩散法(K-B)进行药敏试验,按CLSI 2014年版标准判读药敏试验结果,采用WHONET5.6软件进行数据分析。结果分离菌中革兰阴性菌726株占67.0%,革兰阳性菌357株占33.0%。居前3位的细菌依次为:大肠埃希菌25.5%、肺炎克雷伯菌11.5%、铜绿假单胞菌9.2%,而鲍曼不动杆菌仅为3.8%。大肠埃希菌、克雷伯菌属细菌产超广谱β-内酰胺酶(ESBL)株的检出率分别为49.6%和53.6%。耐亚胺培南的大肠埃希菌和肺炎克雷伯菌的比例分别为0.4%和0.8%。铜绿假单胞菌和鲍曼不动杆菌对所监测药物的耐药率都低于20%,其中碳青霉烯类耐药的鲍曼不动杆菌(CRAB)比例仅为9.8%,未分离到泛耐药的铜绿假单胞菌和鲍曼不动杆菌。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(MRCNA)的检出率分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的53.2%和70.1%,未发现对万古霉素和替考拉宁耐药的葡萄球菌。未分离出耐万古霉素的链球菌属、肠球菌属细菌。万古霉素仍是对革兰阳性球菌抗菌活性最强的药物,碳青霉烯类药物对肠杆菌科等革兰阴性杆菌抗菌活性最强。结论与三甲医院细菌耐药性监测相比,本二级医院分离耐药菌的构成比及药物敏感性存在差异,鲍曼不动杆菌检出率低,耐药水平较低。
[Abstract]:Objective to understand the distribution and drug resistance characteristics of clinical isolates of Ningbo town Hailong hospital in 2015, and to provide the basis for clinical rational selection of antibiotics. Methods 1083 clinical isolates of non repetitive bacteria were collected and the drug sensitivity test was carried out by paper diffusion method (K-B). The results of drug sensitivity test were read according to the standard of CLSI 2014 edition, and WHONET5.6 software was used. Data analysis showed that 726 strains of Gram-negative bacteria were 67%, 357 Gram-positive bacteria accounted for the top 3 of 33.0%., 25.5% of Escherichia coli, 11.5% Klebsiella pneumoniae, 9.2% of Pseudomonas aeruginosa, while Acinetobacter Bauman was only 3.8%. Escherichia coli, and Klebsiella bacteria produced broad-spectrum beta lactamase (ESBL) strain. The ratio of the detection rate of 49.6% and 53.6%. to imipenem and Klebsiella pneumoniae were 0.4%, 0.4% and 0.8%. of Pseudomonas aeruginosa and Acinetobacter Bauman were less than 20%, of which the proportion of carbapenem resistant Acinetobacter (CRAB) was only 9.8%, and the pan resistant copper was not separated. Pseudomonas aeruginosa and Acinetobacter Bauman, methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative staphylococci (MRCNA) accounted for 53.2% and 70.1% of Staphylococcus aureus and coagulase negative staphylococcus, respectively, and no staphylococci resistant to vancomycin and teicoplanin. Streptococcus and enterococcal bacteria. Vancomycin is still the strongest antiseptic to gram-positive cocci. Carbapenems have the strongest antibacterial activity to gram-negative bacilli. Conclusion compared with the bacterial resistance monitoring in tri a hospital, the composition ratio of drug-resistant bacteria in the two level hospital and the drug sensitivity deposit are compared. In contrast, the detection rate of Acinetobacter Bauman was low and the drug resistance level was low.
【作者单位】：宁波市镇海龙赛医院;
【分类号】：R446.5

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