摘要
目的了解贵州某三甲医院2014~2021年5种重要临床菌株耐药性的变迁,为临床合理应用抗菌药物提供理论依据。方法对该院8年间常见的5种重要临床分离菌株进行回顾性分析,采用自动化仪器法及KB法按实验室常规标准操作规程进行药物敏感性试验。根据各年度CLSI判断标准,采用WHONET5.6软件进行分析。结果2014~2021年,该院每年的临床分离菌株数量为5416~8409株。大肠埃希氏菌对第三代头孢菌素耐药的菌株比例为64.7%~68.9%,对亚胺培南、美罗培南和环丙沙星的耐药率分别从0.8%、0.7%、61.8%上升至1.2%、4.1%和69.1%;肺炎克雷伯菌的耐药率在几乎所有抗菌药物都有增长,耐药率增幅较大的体现在碳青霉烯类抗生素,对亚胺培南和美罗培南的耐药率分别从2.2%、1.8%上升至28.2%和41.8%;铜绿假单胞菌对亚胺培南和美罗培南的耐药率在18%和14%左右浮动,其余抗菌药物保持下降趋势;鲍曼不动杆菌对各类抗菌药物的耐药率大多数高于50%,仅是对庆大霉素的耐药率从80%下降至63.5%;甲氧西林耐药金黄色葡萄球菌的检出率相对平稳,对抗菌药物的耐药性呈下降趋势,未发现对万古霉素、利奈唑胺和替考拉宁耐药的菌株。结论常见的5种重要临床菌株中,肺炎克雷伯菌和鲍曼不动杆菌的耐药形式严峻,特别是耐碳青霉烯类肺炎克雷伯菌持续增长,应加强肺炎克雷伯菌的监测和传染病控制措施,指导临床合理用药,防止耐药菌株的传播。
Objective To investigate the antimicrobial resistance trends among five kinds of important clinical isolates in a grade A tertiary hospital in Guizhou Province from 2014 to 2021,and provide laboratory evidences for the clinical prevention and treatment of infectious disease.Methods Retrospective analysis was made on five kinds of important clinical isolates from a grade A tertiary hospital during the past 8 years.Antimicrobial susceptibility testing was carried out according to a unified protocol using automated systems or Kirby-Bauer method.Results were analyzed with WHONET5.6 software.Result From 2014 to 2021,the number of clinical isolates was 5416 to 8409 per year.The proportion of Escherichia coli strains resistant to third-generation cephalosporins was about 64.7%~68.9%,and the resistance rates to imipenem,meropenem and ciprofloxacin increased from 0.8%,0.7%and 61.8%to 1.2%,4.1%and 69.1%,respectively.The resistance rates of Klebsiella pneumoniae increased in almost all antimicrobials,especially for carbapenems,the resistance rates to imipenem and meropenem increased from 2.2%,1.8%to 28.2%and 41.8%,respectively.The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem fluctuated about 18%and 14%,while the other antimicrobials kept downward trend.The resistance rates of Acinetobacter bambini to all kinds of antimicrobials was more than 50%,but gentamicin decreased from 80%to 63.5%,and of carbapenems increased slightly.The detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was relatively stable,the antimicrobial resistance showed a downward trend,there were no resistant strains found to vancomycin,linezolid and teicoplanin.Conclusion Among the five kinds of important clinical isolates,the antimicrobial resistant rates of Klebsiella pneumoniae and Acinetobacter bambini are still in grim situation,especially carbapenem-resistant Klebsiella pneumoniae continue to increase,it is necessary to strengthen the surveillance of Klebsiella pneumonia and the measures for control of infectiou
作者
杨斌
李柔
袁国航
吴瑶瑶
刘琳
Yang Bin;Li Rou;Yuan Guohang;Wu Yaoyao;Liu Lin(Guizhou Provincial People’s Hospital,Guiyang 550025,Guizhou,China;The College of Medicine of Guizhou University,Guiyang 550025,Guizhou,China)
出处
《贵州医药》
CAS
2023年第10期1515-1518,共4页
Guizhou Medical Journal
基金
贵州省卫生健康委科学技术基金(编号:gzwkj2022-255)。
关键词
临床分离菌株
抗菌药物
耐药性
多重耐药
Clinical isolates
Antibiotics
Antimicrobial resistance
Multiple drug resistance
