摘要
目的:监测铜梁区临床分离菌株的耐药情况,评价药学干预后的效果。方法:连续收集铜梁区医疗机构2017~2018年的临床病原菌,采用Kirby-Bauer法或自动化仪器法进行药敏试验,动态分析其耐药数据及抗菌药物使用情况。结果:2017年和2018年临床分离细菌分别为5364株、4869株,其中G+菌为954株、933株,占比17.8%、19.2%;G-菌为4410株、3936株,占比82.2%、80.8%。凝固酶阴性葡萄球菌较金黄色葡萄球菌耐药情况严重,且检出率及耐药率逐年提高,暂未发现对万古霉素和利奈唑胺耐药的葡萄球菌。鲍曼不动杆菌对大多数抗菌药物的耐药率超过50%,2018年对亚胺培南和美罗培南的耐药率分别达58.8%和59.7%,较2017年增长约15个百分点;而2018年铜绿假单胞菌对亚胺培南和美罗培南的耐药率仅为7%和3.9%。肠杆菌科细菌对碳青霉烯类药物及阿米卡星高度敏感。药学干预后,抗菌药物使用相关指标明显改善,但耐碳青霉烯类铜绿假单胞菌(CRPA)分离率、耐碳青霉烯类肠杆菌科细菌(CRE)分离率、耐碳青霉烯类鲍曼不动杆菌(CRAB)分离率有所上升。结论:药学干预对抗菌药物的使用情况改善明显,对细菌耐药也有一定遏制作用;铜梁区整体耐药情况较全国平均水平好,但多耐细菌检出率呈上升趋势。
Objective:To monitor the resistance profile of clinical isolates and evaluate the effect of pharmaceutical intervention in Tongliang district.Methods:Clinical pathogens were collected from 2017 to 2018 in our medical institutions,using Kirby-Bauer method or automated instrument method for drug sensitivity test,dynamic analysis of its drug resistance data and antimicrobial use.Results:The clinical isolation bacteria were 5364 strains/4869 strains in 2017/2018 respectively,of which G+bacteria accounted for 17.8%(954/5364)/19.2%(933/4869),G-bacteria accounted for 82.2%(4410/5364)/80.8%(3936/4869).The coagulase negative staphylococciholded higher drug resistance than staphylococcus aureus,and the detection rate and drug resistance rate increased year by year.Resistance to vancomycin and linezolid were not yet found in staphylococcus.The drug resistance rate of Acinetobacter baumannii was found to exceed 50%in most antimicrobial drugs.The resistance rate to imiminepenem and Meiluopeinan reached 58.8%and 59.7%respectively in 2018,increasing about 15%over 2017.The resistance of Pseudomonas aeruginosa to Meiluopeinan and Pseudomonas aeruginosa was only 7%and 3.9%in 2018.Enterobacterium bacteria are highly sensitive to carbapenes and amikacin.After the pharmaceutical intervention,the index of antibacterial drug usage improved obviously,but the separation rate of carbapenem-resistant Pseudomonasaeruginosa(CRPA),carbapenem-resistant enterobacteriaceae(CRE)and carbopenems-resistant acinetobacter baumannii(CRAB)increased.Conclusion:The use of antimicrobial drugs was obviously improved by pharmaceutical intervention,which also had a deterrent effect on bacterial resistance.The overall drug resistance situation was above the national average,but the detection rate of multi-resistant bacteria was increasing.
作者
余永游
王丹
赵刚
张万萍
YU Yong-you;WANG Dan;ZHAO Gang;ZHANG Wan-ping(Department of Pharmacy,Tongliang People s Hospital,Chongqing 402560,China;Department of Pharmacy,University Town Hospital of Chongqing Medical University,Chongqing 400030,China)
出处
《中国合理用药探索》
CAS
2020年第2期30-36,共7页
Chinese Journal of Rational Drug Use
基金
铜梁区医疗机构细菌耐药情况监测及用药分析项目(TL2018-17)
关键词
耐药监测
抗菌药物
干预效果
drug resistance monitoring
antimicrobial drugs
effect of intervention
