摘要
目的了解2019年首都医科大学附属北京儿童医院临床分离细菌分布及其对抗菌药物的耐药性。方法收集2019年1月1日-12月31日该院临床分离的4854株非重复细菌,采用纸片扩散法、仪器法、部分抗菌药物补充E试验法进行药敏试验,应用WHONET 5.6软件对药敏结果进行分析。结果4854株非重复细菌中,革兰阳性细菌占48.3%,革兰阴性细菌占51.7%。金黄色葡萄球菌占16.8%,其次为流感嗜血杆菌、克雷伯菌属、肺炎链球菌。标本主要来自呼吸道(39.4%)、血液(22.1%)和尿液(10.8%)。金黄色葡萄球菌、表皮葡萄球菌和其他凝固酶阴性葡萄球菌中甲氧西林耐药株(MRSA、MRSE和其他MRCNS)分别占各自菌种的26.7%、83.1%和80.5%,检出3株表皮葡萄球菌和1株松鼠葡萄球菌对利奈唑胺耐药。肠球菌属中检出2株利奈唑胺耐药粪肠球菌和2株利奈唑胺中介屎肠球菌。脑脊液中分离出13株肺炎链球菌,其中青霉素耐药肺炎链球菌(PRSP)8株,占61.5%;非脑脊液标本分离出350株肺炎链球菌,其中PRSP和青霉素中介肺炎链球菌(PISP)分别占2.6%和25.7%。克雷伯菌属(肺炎克雷伯菌和产酸克雷伯菌)、大肠埃希菌和奇异变形杆菌中产ESBL菌株的检出率分别为70.0%、69.9%和26.1%。肠杆菌、鲍曼不动杆菌、铜绿假单胞菌中碳青霉烯类耐药株(CRE、CRAB、CRPAE)分别占27.1%、71.0%和21.0%。535株流感嗜血杆菌对氨苄西林耐药率为71.2%,β内酰胺酶阳性率为69.2%。结论临床分离的常见细菌对不同抗菌药物的耐药率不同,应重视细菌耐药监测,合理使用抗菌药物。
Objective To investigate the distribution and antibiotic resistance profile of clinical isolates in Beijing Children’s Hospital Affiliated to Capital Medical University in 2019.Methods Antimicrobial susceptibility test was conducted by using Kirby-Bauer method or automated system.Results were analyzed by WHONET 5.6 software.Results A total of 4854 clinical isolates were collected from January 1 to December 31,2019,of which gram positive bacteria and gram negative bacteria accounted for 48.3%and 51.7%,respectively.The prevalence of Staphylococcus aureus was the highest(16.8%),followed by Haemophilus influenzae,Klebsiella spp.,and Streptococcus pneumoniae.All the strains were mainly isolated from respiratory tract(39.4%),blood(22.1%)and urine(10.8%).The prevalence of MRSA,MRSE,and other MRCNS in S.aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus was 26.7%,83.1%,and 80.5%.Three strains of S.epidermidis and 1 strain of Staphylococcus sciuri were resistant to linezolid.Two E.faecalis strains were resistant to linezolid and two E.faecium strains were linezolid-intermediate.Thirteen strains of S.pneumoniae were isolated from cerebrospinal fluid,8(61.5%)of which were PRSP.A total of 350 S.pneumoniae strains were isolated from the specimens other than cerebrospinal fluid,of which PRSP and PISP accounted for 2.6%and 25.7%respectively.The prevalence of ESBLs-producing strains was 70.0%in Klebsiella(K.pneumoniae and Klebsiella oxytoca),69.9%in Escherichia coli,and 26.1%in Proteus mirabilis.The prevalence of CRE,CRAB,and CRPAE in Enterobacteriaceae,Acinetobacter baumannii,and Pseudomonas aeruginosa was 27.1%,71.0%,and 21.0%,respectively.About 71.2%of the 535 Haemophilus influenzae strains were resistant to ampicillin,and 69.2%of these strains producedβ-lactamases.Conclusions The common clinical isolates exhibited various levels of resistance to different antimicrobial agents.Antibiotic resistance surveillance is necessary for rational use of antimicrobial agents.
作者
吕志勇
宋文琪
董方
甄景慧
孟庆盈
周为
刘锡青
安璟云
Lü Zhiyong;SONG Wenqi;DONG Fang;ZHEN Jinghui;MENG Qingying;ZHOU Wei;LIU Xiqing;AN Jingyun(Department of Laboratory Medicine,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2021年第3期331-339,共9页
Chinese Journal of Infection and Chemotherapy
关键词
细菌
抗菌药物
耐药性监测
儿童
bacterium
antimicrobial agent
antimicrobial resistance surveillance
children
