摘要
目的分析2013—2020年海南医学院第二附属医院细菌耐药监测的数据,为临床合理选择抗生素提供参考依据。方法从痰液、中段尿、血液、肺泡灌洗液、腹腔积液、伤口脓液和胸腔积液等送检标本中分离、鉴定细菌和进行药敏试验,利用WHONET5.6软件进行统计分析。结果2013—2020年临床标本来源主要是痰液、中段尿和血液,共分离细菌65921株,其中革兰阴性杆菌占65.5%,革兰阳性球菌占23.5%。CTX/CRO-R-ECO、CTX/CRO-R-KPN、QN-R-ECO、CR-ECO和CR-KPN检出率均呈下降趋势,CR-ABA呈缓慢上升趋势。铜绿假单胞菌、大肠埃希菌和鲍曼不动杆菌对常用抗菌药物耐药率高,但呈明显下降势头;肺炎克雷伯菌对常用抗菌药物耐药率高且呈明显上升势头;大肠埃希菌对复方新诺明耐药率及肺炎克雷伯菌对庆大霉素和复方新诺明的耐药率高且基本保持平稳的态势;阴沟肠杆菌、奇异变形杆菌、弗劳地柠檬酸杆菌、摩根摩根菌和普罗威登菌对碳青霉烯类抗生素的耐药率低;铜绿假单胞菌和鲍曼不动杆菌对多粘菌素B的耐药率低;假鼻疽伯克霍尔德菌对常规抗菌药物的耐药率低于6.2%,MRSA、PRSP和VREM均呈缓慢下降的趋势;金黄色葡萄球菌及凝固酶阴性葡萄球菌对庆大霉素和红霉素耐药率均呈逐年下降趋势。结论2013—2020年临床分离菌株重要耐药菌检出率高,但呈现逐渐下降态势。应加强对重要耐药菌的检出率、多粘菌素B耐药率和假性耐药率等数据的监测和复核,为临床提供科学性和合理性的流行病学监测数据。
Objective To analyze units of bacterial resistance monitoring data in The Second Affiliated Hospital of Hainan Medical College of 2013-2020 for clinical rational choice of antibiotics,and we provide an epidemiological reference.Methods Bacteria were isolated and identified from clinical samples including sputum,middle urine,blood,alveolar lavage fluid,abdominal cavity effusion,wound pus and pleural effusion,and drug sensitivity tests were carried out.Excel and WHONET5.6 software were used to integrate,summarize and statistically analyze the test data.Results The top three sources of clinical specimens from 2013 to 2020 were sputum,middle urine and blood.A total of 65921 strains of bacteria were isolated in 8 years,among which the composition ratio of Gram-negative bacilli was 65.5%and that of Gram-positive cocci was 23.5%;CTX/CRO-R-ECO,CTX/CRO-R-KPN,QN-R-ECO,CR-ECO and CR-KPN all showed a decreasing trend,while CR-ABA showed a slowly increasing trend;The drug resistance rates of Pseudomonas aeruginosa,Escherichia coli and Acinetobacter baumannii to commonly used antibiotics were high and showed a trend of moderate decrease,while the drug resistance rates of Klebsiella pneumoniae to commonly used antibiotics were high and showed a trend of moderate increase;The resistance rates of Escherichia coli to cotrimoxazole and Klebsiella pneumoniae to gentamicin and cotrimoxazole were high and basically remained stable.The drug resistance rates of Enterobacter cloacae,Proteus mirabilis,Citrobacter fraudi,Morganella morganella and Providencia to carbapenems were low;The drug resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to polymyxin B were low;the resistance rate of Burkholderia pseudomallei to conventional antibiotics was less than 6.2%;MRSA,PRSP and VREM all showed a slow decreasing trend;The drug resistance rates of Staphylococcus aureus and coagulase-negative Staphylococcus to gentamicin and erythromycin showed a decreasing trend year by year.Conclusions From 2013 to 2020,the detection rate of m
作者
陈林
吴智明
林翀
廖彦
李菲菲
苏应仙
陈伟彬
陈小娟
许玉妮
陈少文
CHEN Lin;WU Zhi-ming;LIN Chong;LIAO Yan;LI Fei-fei;SU Ying-xian;CHEN Wei-bin;CHEN Xiao-juan;XU Yu-ni;CHEN Shao-wen(Department of Clinical Laboratory,The Second Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570203,China)
出处
《中国热带医学》
CAS
2021年第9期855-860,共6页
China Tropical Medicine
基金
海南省医药卫生科研项目(No.琼卫科教〔2014〕51号-14)
海南省卫生健康委科研立项项目(No.琼卫科教〔2019〕13号-117)。
关键词
细菌
耐药
耐药监测
多重耐药菌
Bacteria
drug resistance
drug resistance monitoring
multi-drug resistant bacteria
