摘要
目的了解某医院临床分离细菌的分布特点及耐药情况,为临床合理使用抗菌药物提供参考。方法收集2017年全年自贡市第一人民医院微生物室分离的临床菌株及药敏结果,采用WHONET 5.6软件对数据进行分析统计。结果2017年共分离出细菌3679株,其中革兰阳性菌1033株,占28.1%,革兰阴性菌2646株,占71.9%。分离菌中排名前5位的细菌分别是大肠埃希菌(26.7%)、金黄色葡萄球菌(10.6%)、肺炎克雷伯菌(10.6%)、铜绿假单胞菌(9.2%)和肺炎链球菌(7.0%)。标本类型以痰液和尿液为主,其中痰液以铜绿假单胞菌和肺炎克雷伯菌为主,而尿液以大肠埃希菌和肺炎克雷伯菌为主。分离细菌最多的科室为儿科,占17.6%,其次是普通外科(9.3%)和泌尿外科(6.6%),儿科以金黄色葡萄球菌和肺炎链球菌为主,而普通外科和泌尿外科均以大肠埃希菌为首位。常见革兰阳性菌耐药监测结果为:未分离出耐万古霉素、利奈唑胺或奎奴普丁/达福普汀的金黄色葡萄球菌和肺炎链球菌,其中耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为19.9%,而耐青霉素肺炎链球菌的检出率为0%。而肠球菌中屎肠球菌较粪肠球菌对常见抗菌药物耐药率更高(除外四环素和利奈唑胺),两者对万古霉素和利奈唑胺的耐药率均较低(<4.0%),其中粪肠球菌对万古霉素耐药率为0%。常见革兰阴性菌耐药结果为:大肠埃希菌和肺炎克雷伯菌对头孢吡肟、哌拉西林/他唑巴坦、碳青霉烯类及氨基糖苷类耐药率均较低(<10%),其中产超广谱β⁃内酰胺酶(ESBL)的菌株分别占43.3%和20.8%,且产ESBL菌株较不产ESBL菌株对常见抗菌药物耐药率高;而铜绿假单胞菌对常见抗菌药物耐药率较低,对左氧氟沙星、庆大霉素、妥布霉素、阿米卡星敏感率均为90%以上。结论临床分离菌以革兰阴性菌为主。不同科室及标本类型的常见分离菌的差异较大,临床应根据病原菌的分布特点及�
Objective To understand the distribution and drug resistance of clinical isolates in a hospital,and to provide reference for the rational use of antimicrobial agents.Methods The clinical strains isolated from the microbiology laboratory of Zigong First people’s Hospital in 2017,and the results of drug sensitivity were collected.The data were analyzed by WHONET 5.6 software.Results A total of 3679 strains of bacteria were isolated in 2017,of which 1033 were Gram⁃positive bacteria(28.1%)and 2646 Gram⁃negative bacteria(71.9%).The top five isolates were Escherichia coli(26.7%),Staphylococcus aureus(10.6%),Klebsiella pneumoniae(10.6%),Pseudomonas aeruginosa(9.2%)and Klebsiella pneumoniae(7.0%).Pseudomonas aeruginosa and Klebsiella pneumoniae were the main bacteria isolated in sputum,while Escherichia coli and Klebsiella pneumoniae in urine.The most isolated germs were paediatrics(17.6%),followed by general surgery(9.3%)and urology(6.6%).Staphylococcus aureus and Streptococcus pneumoniae were the main bacteria isolated in pediatrics,while Escherichia coli was the first isolated bacteria in general surgery and urology.The results of drug resistance surveillance of common gram⁃positive bacteria were as follows:vancomycin resistant Staphylococcus aureus and Streptococcus pneumoniae were not isolated.The detection rate of methicillin⁃resistant Staphylococcus aureus(MRSA)was 19.9%and penicillin resistant Streptococcus pneumoniae was 0%.The resistance rate of Enterococcus faecium to common antimicrobial agents was higher than that of Enterococcus faecalis(except tetracycline and linazolamide),and the resistance rates of both to vancomycin and linazolamine were lower(<4.0%),while that of Enterococcus faecium was higher than that of Enterococcus faecalis(except tetracycline and linazolamide).The resistance rate of Enterococcus faecalis to vancomycin was 0%.The results of drug resistance of common Gram⁃negative bacteria were as follows:The resistance rates of Escherichia coli and Klebsiella pneumoniae to cefepime,pi
作者
余建洪
张肃川
徐雪梅
华浩东
何小平
YU Jianhong;ZHANG Suchuan;XU Xuemei;HUA Haodong;HE Xiaoping(Department of Clinical Laboratory,Zigong First People’s Hospital,Zigong,Sichuan 643000,China)
出处
《安徽医药》
CAS
2020年第3期467-472,共6页
Anhui Medical and Pharmaceutical Journal
关键词
微生物敏感性试验
抗药性
细菌
抗药性
多种
细菌
Β内酰胺酶类
氨基糖苷类
革兰氏阴性菌
革兰氏阳性菌
万古霉素
青霉素类
Microbial sensitivity tests
Drug resistance
bacterial
Drug resistance,multiple,bacterial
beta⁃Lactamases
Aminoglycosides
Gram⁃negative bacteria
Gram⁃positive bacteria
Vancomycin
Penicillins
