摘要
目的:了解安康市中心医院(以下简称"我院")临床分离的细菌的耐药性,为指导合理用药提供依据。方法:收集2016—2017年我院临床分离的5 614株非重复细菌,采用纸片扩散法(K-B法)或自动化仪器法进行药物敏感试验,按美国临床和实验室标准协会2015年版标准判读药物敏感试验结果,采用WHONET 5.6软件进行数据分析。结果:5 614株细菌中,革兰阳性菌1 415株(占25.2%),革兰阴性菌4 199株(占74.8%);分离率排序居前5位的细菌依次为肺炎克雷伯杆菌、大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌和阴沟肠杆菌。与2016年比较,2017年肺炎克雷伯菌对阿米卡星、头孢他啶、头孢吡肟及氨曲南的耐药率升高;鲍曼不动杆菌除对以上4种抗菌药物的耐药率升高外,对哌拉西林他唑巴坦、亚胺培南的耐药率也升高;阴沟肠杆菌对阿米卡星、头孢他啶、哌拉西林他唑巴坦、氨曲南及亚胺培南的耐药率降低;金黄色葡萄球菌、表皮葡萄球菌对头孢呋辛、苯唑西林、头孢西丁、克林霉素及红霉素的耐药率升高。2017年多重耐药菌检出率较2016年明显升高,差异有统计学意义(P<0.05)。结论:2017年我院细菌耐药性呈增强趋势,应继续重视细菌耐药性监测,加强抗菌药物的合理应用,采取有效的医院感染控制措施。
OBJECTIVE： To investigate the bacterial resistance in clinical isolates from Ankang Central Hospital（ hereinafter referred to as ＂our hospital＂）,so as to provide a basis for guiding rational application of drugs.METHODS： A total of 5 614 non-repetitive bacteria isolated from our hospital during 2016-2017 were collected. Drug sensitivity tests were performed by disk diffusion method（ K-B） or automated instrumentation. Drug sensitivity test results were interpreted according to the American Society for Clinical and Laboratory Standards（ 2015）, and WHONET 5. 6 software was used for data analysis. RESULTS： Among the 5 614 strains of bacteria,1 415 were grampositive bacteria（ 25. 2%） and 4 199 were gram-negative bacteria（ 74. 8%）; the top 5 isolates were klebsiella pneumoniae,escherichia coli,pseudomonas aeruginosa,staphylococcus aureus and enterobacter cloacae. Compared with 2016,the resistance rate of klebsiella pneumoniae to amikacin,ceftazidime,cefepime and aztreonam increased in2017; in addition to the increased resistance rate of Acinetobacter baumannii to the above four antimicrobial agents,the resistance rate to piperacillin tazobactam and imipenem was also increased. The resistance rate of enterobacter cloacae to amikacin,ceftazidime,piperacillin tazobactam,aztreonam and imipenem decreased. And the resistance rate of staphylococcus aureus and staphylococcus epidermidis to cefuroxime, oxacillin, cefoxitin, clindamycin and erythromycin increased. The detection rate of multi-drug resistant bacteria in 2017 was significantly higher than that in2016,and the difference was statistically significant（ P〈0. 05）. CONCLUSIONS： In 2017,the bacterial resistance of the hospital showed an increasing trend. It is necessary to pay attention to the monitoring of bacterial resistance,strengthen the rational application of antibiotics and take effective measures to control the nosocomial infections.
作者
王丹婷
尹志国
祁平
赵正杭
WANG Danting;YIN Zhiguo;QI Ping;ZHAO Zhenghang(Dept.of Pharmacology,Xi＇an Jiaotong University Health Science Center,Shaanxi Xi＇an 710061,China;Dept.of Pharmacy,Ankang Central Hospital,Shaanxi Ankang 725000,China)
出处
《中国医院用药评价与分析》
2018年第9期1275-1278,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
抗菌药物
耐药性
多重耐药菌
Antibiotics
Resistance
Multi-drug resistant bacteria
