摘要
目的 分析2014—2017年广州市红十字会医院临床分离病原菌的分布及耐药特点。方法 对2014年1月至2017年12月广州市红十字会医院各临床科室送检标本采用全自动细菌分析、纸片扩散法进行细菌鉴定和抗菌药物敏感性试验。结果 共分离15851菌株病原菌,其中革兰阳性菌占31.5%,革兰阴性菌占68.5%。金黄色葡萄球菌和凝固酶阴性葡萄球菌中耐甲氧西林菌株的检出率分别为47.2%和82.1%,未发现对万古霉素、替考拉宁、利奈唑胺耐药的菌株。2017年主要革兰阴性菌对大多数抗菌药物的耐药率较2014—2015年有下降趋势。大肠埃希菌和肺炎克雷伯菌对碳青霉烯类、哌拉西林他唑巴坦、头孢哌酮/舒巴坦及阿米卡星等药物耐药率较低,铜绿假单胞菌对部分药物的耐药率有下降趋势,但对碳青霉烯类药物的耐药率仍较高。鲍曼不动杆菌仅对多黏菌素B耐药率低,对头孢哌酮舒巴坦、米诺环素耐药率在60%左右,对碳青霉烯类及其他药物耐药率达80%以上,2017年鲍曼不动杆菌对碳青霉烯类药物的耐药率略有下降。结论 2017年主要革兰阴性菌耐药性对临床常用部分抗菌药物的耐药性较2014—2015年下降,但仍较严重,特别是对碳青霉烯类药物耐药的革兰阴性菌耐药仍应引起临床高度重视。
Objective To investigate the distribution and antimicrobial resistance in clinical isolates of pathogens in Guangzhou Red Cross Hospital during 2014-2017. Methods All the objective bacterial isolates were collected in Guangzhou Red Cross Hospital from Jan.2014 to Dec.2017,using Kirby-Bauer disc diffusion method and automatic bacterial analyzer for bacteria identification and antimicrobial susceptibility test. Results Altogether 15 851 bacterial isolates, including 31.5% Gram-positive bacteria and 68.5% Gram-negative bacteria. Methicillin-resistant strains in S. aureus and coagulase negative Staphylococcus accounted for 47.2% and 82.1%, respectively, no bacterial was found resistant to vancomycin ,teicoplanin and linezolid.The major Gram-negative bacterial isolates showed a declined antibiotic resistance to most antibacterial agents in 2017 compared to 2014-2015.E.coli and Klebsiella pneumoniae kept a lower resistant rate to carbapenem,piperacillin-tazobactam,cefoperazone-sulbactam and amikacin.The resistance of Pseudomonas aeruginosa to part of the antibiotics decreased,yet it remained higher to carbapenem.The antibiotic resistance of acinetobacter baumannii to polymyxin B was low,and the resistant rate to cefoperazone-sulbactam and minocycline was around 60%,while the resistant rate to carbapenem and other clinical common antibacterial agents were more than 80%,though the resistant rate to carbapenem was slightly declined in 2017. Conclusion The antibiotic resistance of Gram-negative bacteria declined in 2017 compared to 2014-2015,but was still serious, especially that the carbapenem-resistant Gram-negative bacteria should be paid more attention.
作者
梁忆华
张敏
钟海波
汪得喜
李勤
彭湘明
LIANG Yihu;ZHANG Min;ZHONG Haibo;WANG Dexi;LI Qin;PENG Xiangming(Department of Pneumology, Guangzhou Red Cross Hospital,Guangzhou 510220,China;Department of Infectious Diseases,Guangzhou Red Cross Hospital,Guangzhou 510220,China;Department of Clinical Laboratory,Guangzhou Red Cross Hospital,Guangzhou 510220,China)
出处
《医学综述》
2019年第11期2279-2284,共6页
Medical Recapitulate
基金
国家自然科学基金(81100042)
关键词
抗菌药物
耐药性
碳青霉烯酶
多重耐药菌
Antibacterial agents
Antibiotic resistance
Carbapenemases
Multiple resistant bacteria
