摘要
目的:分析医养结合机构常见病原菌对抗菌药物的敏感性及耐药性,为此类机构临床早期经验性治疗提供选药参考依据。方法:按照2013年CLSI推荐的药敏试验方法和标准,对2017年1-12月全年送检标本进行试验及结果判断。结果:共送检标本7878份,分离出阳性标本1981份,总体阳性率25. 15%。病原菌以革兰阴性菌为主(76. 53%),革兰阳性菌占12. 87%,真菌占10. 60%。检出前5位病原菌的抗菌药物耐药率、敏感率为:铜绿假单胞菌对左氧氟沙星耐药率最高为35. 5%,对阿米卡星敏感率为97. 4%;大肠埃希菌对头孢唑林耐药率最高为84. 8%,对亚胺培南西司他丁敏感率为95. 9%;肺炎克雷伯菌对复方新诺明耐药率最高为66. 3%,对阿米卡星敏感率为88. 4%;金黄色葡萄球菌对阿奇霉素耐药率最高为57. 7%,对万古霉素敏感率为100. 0%;鲍曼不动杆菌对头孢他啶耐药率最高为85. 7%,对多黏菌素B敏感率为93. 9%。结论:医养结合、长期照护机构应尽快开展细菌耐药监测工作,为其临床合理使用抗菌药物提供参考依据。
Objective: To analyze the sensitivity and drug resistance of common pathogens to antibacterials in integrated medical treatment and elderly nursing institutions, so as to provide reference for early empirical treatment in such institutions. Methods: From January 2017 to December 2017,the samples were tested and judged according to the drug sensitivity test methods and standards recommended by CLSI in 2013. Results: A total of 7878 samples were sent for examination,1981 positive samples were isolated,and the overall positive rate was 25. 15%. Gram-negative bacteria( 76. 53%),Gram-positive bacteria( 12. 87%) and fungi( 10. 60%) were the main pathogens. The drug-resistant rate and sensitive rate of the top five pathogenic bacteria were as follows: the highest resistant rate of Pseudomonas aeruginosa to levofloxacin was 35. 5%,and the sensitive rate to amikacin was 97. 4%;the highest resistant rate of E. coli to cefazolin was 84. 8%,and the sensitive rate to imipenem cilastatin was 95. 9%;the highest resistant rate of Klebsiella pneumoniae to trimesulf was 66. 3%,and the sensitive rate to amikacin was 88. 4%;the highest resistant rate of Staphylococcus aureus to azithromycin was 57. 7%,and the sensitive rate to vancomycin was 100. 0%;the highest resistant rate of Acinetobacter baumannii to ceftazidime was 85. 7%,and the sensitive rate to polymyxin B was 93. 9%. Conclusion: The monitoring of bacterial resistance should be carried out as soon as possible in the longterm care institutions and integrated medical treatment and elderly nursing institutions,so as to provide a reference for rational use of antibiotics in clinic.
作者
曾琳
李凤玉
Zeng Lin;Li Fengyu(Chengdu Eighth People's Hospital,Chengdu,Sichuan 610083,China)
出处
《现代临床医学》
2019年第5期335-337,共3页
Journal of Modern Clinical Medicine
关键词
医养结合机构
病原菌
敏感性
耐药性
medical and nursing institutions
pathogens
sensitivity
drug resistance
