摘要
目的了解2017年鄂尔多斯市中心医院临床分离病原菌耐药状况,为临床合理使用抗菌药物和抗感染治疗提供参考依据。方法 2017年共收集2628株临床非重复分离菌,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。参照2015年CLSI标准判定药敏结果,并用WHONET 5.6软件进行数据统计分析。结果 2017年共收集2628株临床非重复分离菌,其中革兰阴性菌2178株,占82.9%,革兰阳性菌450株,占17.1%。分离前5位的细菌是:大肠埃希菌(19.9%)、肺炎克雷伯菌(16.9%)、铜绿假单胞菌(9.5%)、鲍曼不动杆菌(8.7%)和阴沟肠杆菌(6.6%)。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(MRCNS)的检出率分别为19.7%和61.1%,未发现耐万古霉素葡萄球菌和耐万古霉素肠球菌。大肠埃希菌和肺炎克雷伯菌中产ESBL株分别占47.6%和16.9%,碳青霉烯类耐药肠杆菌科细菌(CRE)14株,占肠杆菌科细菌0.9%。耐亚胺培南铜绿假单胞菌(CRPA)和鲍曼不动杆菌(CRAB)的检出率分别为7.4%和42.8%。结论细菌耐药性,尤其是MRSA、CRE、CRPA和CRAB所致的耐药性不容忽视,应引起重视。加强细菌耐药性监测有助于了解本院细菌耐药性的发生和变迁,并为抗菌药物的合理应用和管理提供科学的参考依据。
Objective To investigate the antibiotic resistance profile of clinical isolates in Ordos Central Hospital during 2017 for rational uses of antimicrobial drugs and clinical anti-infective therapy.Methods A total of 2 628 non-duplicate clinical isolates were collected during 2017.The isolates were subjected to identification on VITEK 2-Compact system.Automated system and Kirby-Bauer method were used to test the susceptibility of these isolates.The results were interpreted according to CLSI 2015 breakpoints.The data were processed and analyzed with WHONET 5.6 software.Results Of the 2 628 strains collected in 2017,gram-negative bacteria accounted for 82.9%(2 178/2 628)and gram-positive bacteria accounted for 17.1%(450/2 628).The top five pathogens were Escherichia coli(19.9%),Klebsiella pneumonia(16.9%),Pseudomonas aeruginosa(9.5%),Acinetobacter baumannii(8.7%),and Enterobacter cloacae(6.6%).The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)was 19.7%in Staphylococcus aureus,and the prevalence of methicillin-resistant coagulase negative Staphylococcus(MRCNS)was 61.1%among coagulasenegative Staphylococcus(CNS).No vancomycin-resistant Enterococcus(VRE)or Staphylococcus was found.ESBLs-producing strains accounted for 47.6%in Escherichia coli and 16.9%in Klebsiella pneumonia isolates.A total of 14(0.9%)carbapenemresistant strains were identified among Enterobacteriaceae isolates.The prevalence of imipenem-resistant Acinetobacter baumannii was 42.8%.The prevalence of imipenem-resistant Pseudomonas aeruginosa was 7.4%.Conclusions The issue of antimicrobial resistance is of critical concern,esspecially MRSA,CRE,and carbapenem-resistant P.aeruginosa and A.baumannii.Ongoing surveillance of bacterial resistance is helpful for understanding the status of bacterial resistance,and can inform rational use of antimicrobial agents.
作者
巴特尔
王新刚
姜大伟
杜介方
王叶花
BA Teer;WANG Xingang;JIANG Dawei;DU Jiefang;WANG Yehua(Department of Laboratory Medicine,Ordos Central Hospital,Ordos Inner Mongolia 017000,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2019年第2期187-194,共8页
Chinese Journal of Infection and Chemotherapy
关键词
抗菌药物
耐药性分析
药物敏感性试验
antimicrobial agent
bacterial resistance profile
antimicrobial susceptibility testing
