摘要
目的 了解2016-2020年甘肃省某三甲医院临床分离菌株分布情况及对抗菌药物的耐药性变迁,为临床合理使用抗菌药物提供依据。方法 收集2016年1月-2020年12月医院临床分离菌,根据美国临床和实验室标准化协会(CLSI)标准判读药敏结果,采用WHONET 5.6软件和SPSS 26.0软件进行数据分析。结果 2016-2020年共收集非重复菌株15 889株,其中革兰阴性菌10 786株(67.9%),革兰阳性菌5 103株(32.1%)。排名前五位分离菌为大肠埃希菌3 340株(21.0%)、金黄色葡萄球菌2 130株(13.4%)、肺炎克雷伯菌1 605株(10.1%)、鲍氏不动杆菌1 582株(10.0%)、铜绿假单胞菌1 138株(7.2%)。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)菌株分别为2 061株(61.7%)和600株(37.4%),耐碳青霉烯大肠埃希菌(CRECO)、耐碳青霉烯鲍氏不动杆菌(CRAB)、耐碳青霉烯肺炎克雷伯菌(CRKP)的检出率分别为1.1%(37/3340)、83.6%(1323/1582)和5.0%(80/1605),耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为44.1%(940/2130)和74.6%(381/511),未发现对万古霉素和利奈唑胺耐药的葡萄球菌属和肠球菌属菌株。结论 细菌耐药状况日益严重,耐碳青霉烯类革兰阴性菌的检出率持续上升,应引起临床高度重视,并合理选用抗菌药物,采取有效措施,以控制和减少院内感染的风险,同时做好细菌耐药监测工作。
OBJECTIVE To understand the distribution and drug resistance of clinical strains isolated from a three-A hospital of Gansu Province between 2016 and 2020 so as to provide guidance for reasonable clinical use of antibiotics. METHODS The clinical strains were collected from the hospital from Jan 2016 to Dec 2020. The result of drug susceptibility testing was interpreted on basis of standards of Clinical and Laboratory Standards Institute(CLSI), and the data were analyzed by using WHONET5.6 software and SPSS 26.0 software. RESULTS A total of 15889 strains of non-repetitive isolates were collected between 2016 and 2020, 10786(67.9%) of which were gram-negative bacteria, 5103(32.1%) were gram-positive bacteria. Escherichia coli(3340 strains, 21.0%), Staphylococcus aureus(2130 strains, 13.4%), Klebsiella pneumoniae(1605 strains, 10.1%), Acinetobacter baumannii(1582 strains, 10.0%) and Pseudomonas aeruginosa( 1138 strains, 7.2%) ranked the top 5 species of isolates. There were 2061(61.7%) strains of extended-spectrum β-lactamases(ESBLs)-producing E.coli and 600(37.4%) strains of ESBLs-producing K.pneumoniae. The isolation rates of carbapenem-resistant E.coli(CREO), carbapenem-resistant A.baumannii(CRAB) and carbapenem-resistant K.pneumoniae(CRKP) were 1.1%(37/3340), 83.6%(1323/1582) and 5.0%(80/1605), respectively. The isolation rates of methicillin-resistant S.aureus(MRSA) and methicillin-resistant coagulase-negative Staphylococcus(MRCNS) were 44.1%(940/2130) and 74.6%(381/511), respectively. No strains of Staphylococcus or Enterococcus that were resistant to vancomycin, teicoplanin or linezolid were found. CONCLUSION The drug resistance of the isolated strains is increasingly serious. The isolation rate of carbapenem-resistant gram-negative bacteria continues to rise. It is necessary to reasonably use antibiotics, take effective measures and monitor the bacterial resistance so as to reduce the risk of nosocomial infection.
作者
刘萌
张浩军
李可可
张映华
杨亚红
崔亚丽
关晓雯
王雯婕
焦凤媛
魏莲花
LIU Meng;ZHANG Hao-jun;LI Ke-ke;ZHANG Ying-hua;YANG Ya-hong;CUI Ya-li;GUANXiao-wen;WANGWen-jie;JIAOFeng-yuan;WEI Lian-hua(Ning Xia Medical University,Yinchuan,Ningria 750004,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第9期1415-1420,共6页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(81960385)。
关键词
细菌耐药性
耐药率
抗菌药物
多药耐药菌
Antibacterial resistance
Drug resistance rate
Antibiotic
Multidrug-resistant organism
