摘要
目的了解肝病患者主要病原菌检出及分布情况,以及病原菌的耐药性趋势变化,为临床应用抗菌药物提供参考。方法收集2014-2016年的临床分离株,采用自动化仪器法或纸片扩散法按统一方案进行细菌药物敏感性试验,根据CLSI标准判断结果。结果 3年共检出4 251株病原菌,主要来源于胆汁引流液、随机血液和腹水。分离数列前6位的分别是大肠埃希菌(15.01%)、凝固酶阴性葡萄球菌(12.66%)、屎肠球菌(11.93%)、肺炎克雷伯菌(10.61%)、铜绿假单胞菌(8.45%)和嗜麦芽窄食单胞菌(5.74%);CRE检出128株、分离率6.89%,CRAB检出63株、分离率74.67%,CRPA检出203株、分离率56.55%,VRE检出32株、分离率4.60%,MRSA检出38株、分离率27.04%;大肠埃希菌仅对哌拉西林他唑巴坦、头孢哌酮舒巴坦和阿米卡星的敏感性较好,肺炎克雷伯菌对三代和四代头孢、哌拉西林他唑巴坦、头孢哌酮舒巴坦和阿米卡星的敏感性较好,鲍曼不动杆菌仅对头孢哌酮舒巴坦的耐药性较低,铜绿假单胞菌对碳氢酶烯和氨曲南的耐药性逐年递增、对阿米卡星和头孢哌酮的敏感性最好,肠球菌属对替考拉宁、利奈唑胺和万古霉素敏感性最好,凝固酶阴性葡萄球菌对苯唑西林、红霉素和环丙沙星严重耐药,金黄色葡萄球菌对红霉素耐药性较高,白色念珠菌对各抗真菌药物的敏感性均较好。结论细菌耐药形势严峻,需进一步加强对细菌耐药性的监测,提高医务人员的合理用药意识,防止或减缓耐药菌株的产生。
Objective To understand main pathogens detection and distribution of patients with hepatobiliary disease, as well as the main trend of the drug resistance of pathogenic bacteria, so as to provide basis for clinical rational use of antimicrobial drugs. Methods Isolated bacteria from 2014 to 2016 was collected. Drug sensitivity test was taken with disk diffusion method or automatic instrument method. The results were judged according to CLSI standard. Results A total of 4 251 pathogens were detected in 3 years, mainly derived from bile drainage fluid, random blood and ascites. The main pathogens were Escherichia coli, Coagulase negative staphylococci, Enterococcus faecium, Klebsiellapneumonia,Pseudomonas aeruginosa, Stenotrophomonasmaltophilia, accounting for 15.01%, 12.66%, 11.93%, 10.61%, 8.45% and5.74%. 128 strains of CRE were detected, with the isolation rate was 6.89%; 63 strains of CRAB were detected, with the isolation rate was 74.67%; 203 strains of CRPA were detected, with the isolation rate was 56.55%; 32 strains of VRE were detected, with the isolation rate was 4.60%; 38 strains of MRSA were detected, with the isolation rate was 27.04%. E.coli was only sensitive to piperacillin-tazobactam, cefoperazone-sulbactam and amikacin; KPN was sensitive to the three generation cephalosporin,the fourth-generation cephalosporins, piperacillin-tazobactam, cefoperazone-sulbactam and amikacin; ABA on cefoperazone-sulbactam had high rate of drug sensitivity; the resistance to hydrocarbon enzymes and aztreonam of PAE had been increasing year by year, with high rate of drug sensitivity on amikacin and cefoperazone; the susceptibility of Enterococcus to teicoplanin, linezolid and vancomycin was high; coagulase negative staphylococci were highly resistant to oxacillin, erythromycin, and ciprofloxacin; Staphylococcusaureus had higher resistance to erythromycin; Blastomycesalbicans was sensitive to all antifungal agents. Conclusion The drug resistance of clinical isolates shows severe.It is necessary to strengthen the monitor
出处
《北京医学》
CAS
2017年第12期1220-1224,1228,共6页
Beijing Medical Journal
关键词
病原菌
抗菌药物
耐药性
pathongenic bacterial
antibiotic
drug resistance
