摘要
目的:统计分析四川省邛崃市医疗中心医院2018~2020年病原菌分布及耐药情况,为本地区合理用药提供依据。方法:采用本院2018~2020年住院和门诊患者临床标本中分离的非重复病原菌,用自动化仪器检测法或标准纸片扩散法,测定监测药物对细菌的敏感性,并依据美国临床和实验室标准协会(CLSI)2020年标准,使用WHONET 5.6软件进行数据统计分析。结果:从临床标本中分离出9352株病原菌,其中革兰阴性菌5950株(63.6%),革兰阳性菌3402株(36.4%);检出率前5位的病原菌依次为大肠埃希菌(20.3%)、肺炎克雷伯菌(14.0%)、肺炎链球菌(9.5%)、金黄色葡萄球菌(9.0%)、铜绿假单胞菌(7.3%);病原菌主要来源于痰液(43.1%)、尿液(11.9%)、分泌物(10.6%)、胸水(9.7%)及血液(6.4%)。大肠埃希菌、肺炎克雷伯菌对碳青霉烯类、酶抑制剂药物耐药率低于2.0%。金黄色葡萄球菌和凝固酶阴性葡萄球菌中甲氧西林耐药株(MRSA和MRCNS)检出率分别为19.2%和65.1%,未发现万古霉素、利奈唑胺、奎奴普丁/达福普汀的耐药株。屎肠球菌对万古霉素的耐药率从2018年的1.3%下降至2020年的0.0%。结论:本地区临床分离菌株对常用抗菌药物耐药性仍较高,长期监测可充分了解本地区细菌耐药趋势变化,指导临床合理用药,减缓多重耐药菌的出现。
Objective:To analyze the distribution and drug resistance of pathogenic bacteria in Qionglai Medical Center Hospital of Sichuan Province from 2018 to 2020,and to provide the basis for rational drug use in this area.Methods:Non-repetitive pathogens isolated from clinical specimens of inpatients and outpatients in our hospital during 2018 to 2020 were used to determine the susceptibility of the monitored drugs to bacteria by automated instrument detection or standard paper diffusion method.The data were statistically analyzed using WHONET 5.6 software according to Clinical and Laboratory Standards Institute(CLSI)2020 standard.Results:9352 strains of pathogenic bacteria were isolated from the clinical specimens,including 5950 strains of Gram-negative bacteria(63.6%)and 3402 strains of Gram-positive bacteria(36.4%).The top five detection rate of strains were Escherichia coli(20.3%),Klebsiella pneumoniae(14.0%),Streptococcus pneumoniae(9.5%),Staphylococcus aureus(9.0%)and Pseudomonas aeruginosa(7.3%).The pathogens were mainly derived from sputum(43.1%),urine(11.9%),secretions(10.6%),pleural effusion(9.7%)and blood(6.4%).The drug resistance rate of Escherichia coli and Klebsiella pneumoniae to Carbapenems and Enzyme inhibitors were lower than 2.0%.The detection rates of methicillin-resistant staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative staphylococcus(MRCNS)in Staphylococcus aureus and Coagulase-negative Staphylococcus were 19.2%and 65.1%,respectively.No resistance strains to vancomycin,linezolid,and quinupridine/dafoptin were found.The drug resistance rate of Enterococcus faecium to vancomycin decreased from 1.3%in 2018 to 0.0%in 2020.Conclusion:The resistance of clinical isolated strain to commonly used antimicrobial agents was still high in this area.Long-term monitoring can fully understand the trend of bacterial resistance in this area,guide clinical rational drug use,and reduce the occurrence of multi-drug resistant bacteria.
作者
徐毅
罗建蓉
张敏
杨利
杨洁
龙姗姗
XU Yi;LUO Jian-rong;ZHANG Min;YANG Li;YANG Jie;LONG Shan-shan(Clinical Laboratory of Department,Medical Center Hospital of Qionglai City,Chengdu 611530,China)
出处
《中国合理用药探索》
CAS
2021年第5期37-43,共7页
Chinese Journal of Rational Drug Use
关键词
病原菌
耐药性
抗菌药物
细菌分布
监测
pathogen
drug resistance
antimicrobial agents
distribution of bacteria
monitoring
