2012—2014年某教学医院肠杆菌科细菌耐药率变迁

发布时间：2019-03-16 09:00

【摘要】：目的了解某医学院附属医院2012—2014年肠杆菌科细菌的标本类型、送检科室分布情况及3年间的耐药性变迁情况。方法收集3年间医院临床微生物室临床首次分离的肠杆菌科细菌,采用美国BD公司Phoenix100全自动微生物分析系统进行菌种鉴定和抗菌药物敏感试验,药敏结果判断标准遵循CLSI2013指南,数据结果采用WHONET5.6软件进行分析。结果 2012—2014年医院共收集首次分离肠杆菌科细菌9 031株,送检科室以重症医学科(ICU)、神经外科、神经内科、泌尿科和呼吸内科为主;标本类型以呼吸道、泌尿道、血液标本、分泌物、胸腹水和脑脊液为主;病原菌以肺炎克雷伯菌、大肠埃希菌、奇异变形杆菌、阴沟肠杆菌、粘质沙雷菌和产气肠杆菌为主;药物敏感试验显示碳青霉稀类、加酶抑制剂和氨基糖苷类抗菌药物敏感率较高,其余抗菌药物敏感率均较低。结论肠杆菌科细菌是医院重要的病原菌,对多种抗菌药物均表现为高水平耐药和多重耐药。目前,碳青霉烯类抗菌药物仍然是治疗肠杆菌科细菌临床感染的最佳选择,但是,碳青霉烯类耐药的肠杆菌科细菌(Carbapenem-Resistant Enterobacteriaceae,CRE)已经出现,且呈增多趋势,需加强CRE监测和规范临床合理用药,以遏制CRE在医院内的传播。
[Abstract]:Objective to investigate the specimen types of Enterobacteriaceae bacteria from 2012 to 2014 in a affiliated hospital of a medical college, the distribution of bacteria in the department of inspection and the change of drug resistance in the past 3 years. Methods Enterobacteriaceae bacteria isolated for the first time in clinical microbiology department of hospital in 3 years were collected. The bacteria identification and antimicrobial susceptibility test were carried out by Phoenix100 automatic microbiological analysis system of BD Company, USA. The criteria for judging the drug sensitivity results were in accordance with the CLSI2013 guidelines. The data results were analyzed by WHONET5.6 software. Results from 2012 to 2014, 9 031 strains of Enterobacteriaceae were collected for the first time in the hospital. (ICU), neurosurgery, neurology, urology and respiratory medicine were the main departments in the examination department. The main pathogens were Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis, Enterobacter cloacae, Serratia mucilis and Enterobacter aerogenes, and the main pathogens were Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis, Enterobacter cloacae, Serratia mucilis and Enterobacter aerogenes. Drug sensitivity test showed that the susceptibility rates of carbapenicillium, enzyme inhibitors and aminoglycosides were higher than those of other antimicrobial agents. Conclusion Enterobacteriaceae is an important pathogen in hospital. At present, carbapenem antibiotics are still the best choice for the treatment of Enterobacteriaceae clinical infection. However, carbapenem-resistant Enterobacteriaceae bacteria (Carbapenem-Resistant Enterobacteriaceae,CRE) have appeared and showed an increasing trend. In order to control the spread of CRE in hospital, it is necessary to strengthen the monitoring of CRE and standardize the rational use of drugs in clinic.
【作者单位】：徐州医学院附属医院检验科;
【分类号】：R378.2

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