2014年天津市血流感染细菌耐药监测

发布时间：2019-03-22 13:03

【摘要】：目的:研究天津市血流感染细菌耐药分布及耐药性。方法:收集2014年度天津市45家医院血标本来源细菌药敏结果,用CLSI 2014年标准判读,WHONET5.6进行药物敏感性分析。结果:分离共计4 772株细菌,其中革兰阳性菌2 038株,占42.7%,革兰阴性菌2 734株,占57.3%,葡萄球菌属1 409株,占29.5%,肠球菌属335株占7.0%,肠杆菌科细菌2 248株,占47.1%,非发酵菌438株,占9.2%,肺炎链球菌35株,占0.7%。最常见细菌依次为大肠埃希菌(27.3%)、凝固酶阴性葡萄球菌(23.8%)、肺炎克雷伯菌(12.1%)、金黄色葡萄球菌(5.6%)、铜绿假单胞菌(4.1%)。耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和耐甲氧西林金黄色葡萄球菌(MRSA)的检出率分别为78.5%和25.3%。MRSA和MRCNS的耐药率明显高于甲氧西林敏感金黄色葡萄球菌(MSSA)和甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS)。未发现对万古霉素耐药的葡萄球菌。粪肠球菌和屎肠球菌对万古霉素敏感率分别为100%和98.1%,共检出耐万古霉素的屎肠球菌(VRE)3株。大肠埃希菌对亚胺培南的敏感率为98.7%,肺炎克雷伯菌对亚胺培南的敏感率为95.3%。大肠埃希菌和肺炎克雷伯菌中产ESBLs株分别占60.1%和33.3%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为21.6%和17.5%。鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别为39.6%和49.3%。结论:本年度所分离血培养细菌的耐药较为普遍,加强耐药性监测,指导临床合理使用抗菌药物十分重要。
[Abstract]:Objective: to study the drug resistance distribution and drug resistance of blood flow infection bacteria in Tianjin. Methods: the results of drug sensitivity of blood samples from 45 hospitals in Tianjin in 2014 were collected. The drug sensitivity was analyzed by CLSI 2014 standard and WHONET5.6. Results: a total of 4 772 strains of bacteria were isolated, of which 2038 were Gram-positive (42.7%), 2 734 Gram-negative (57.3%), 1 409 Staphylococcus (29.5%), 335 Enterococci (7.0%). There were 2 248 strains (47.1%) in Enterobacteriaceae, 438 strains (9.2%) in non-fermentative bacteria and 35 strains (0.7%) in Streptococcus pneumoniae. The most common bacteria were Escherichia coli (27.3%), coagulase negative staphylococcus (23.8%), Klebsiella pneumoniae (12.1%), Staphylococcus aureus (5.6%) and Pseudomonas aeruginosa (4.1%). The positive rates of methicillin-resistant coagulase-negative staphylococcus (MRCNS) and methicillin-resistant Staphylococcus aureus (MRSA) were 78.5% and 78.5% respectively. The drug-resistant rates of 25.3%.MRSA and MRCNS were significantly higher than those of methicillin-sensitive Staphylococcus aureus. Staphylococcus (MSSA) and methicillin sensitive coagulase negative Staphylococcus (MSCNS). Staphylococcus resistant to vancomycin was not found. The susceptibility rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 100% and 98.1%, respectively. Three strains of vancomycin-resistant Enterococcus faecium (VRE) were detected. The susceptibility rate of Escherichia coli to imipenem and Klebsiella pneumoniae to imipenem was 98.7% and 95.3% respectively. Escherichia coli and Klebsiella pneumoniae accounted for 60.1% and 33.3% of ESBLs strains, respectively. The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 21.6% and 17.5%, respectively. The resistance rates of Acinetobacter baumannii to imipenem and meropenem were 39.6% and 49.3%, respectively. Conclusion: the drug resistance of isolated blood culture bacteria is more common in this year. It is very important to strengthen the monitoring of drug resistance and guide the rational use of antibiotics in clinic.
【作者单位】：天津市第一中心医院检验科;
【基金】：国家临床重点专科建设项目(检验专业)资金资助(编号:2013-544)
【分类号】：R446.5

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