摘要
目的了解2016年上海市某院临床常见标本中细菌的分布和耐药性变迁,为临床合理使用抗菌药物提供依据。方法收集2016年1-12月上海市宝山区中西医结合医院患者标本分离的细菌,按CLSI M100-S26标准判断结果,采用WHONET5.6软件对数据进行统计分析。结果 1 920株非重复分离菌中革兰阴性菌1 385株,占72.14%;革兰阳性菌535株,占27.86%。葡萄球菌属中未发现对万古霉素、利奈唑胺耐药的菌株。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)检出率分别为56.16%和63.41%。屎肠球菌对多数抗菌药物耐药率高于粪肠球菌。发现1株耐万古霉素的屎肠球菌。大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)的检出率分别为42.06%(106/252)、45.39%(143/315),产ESBLs菌株对大多数抗菌药物的耐药率明显高于非产ESBLs菌株。鲍曼不动杆菌对碳青霉烯类药物的耐药率达60%以上,铜绿假单胞菌对阿米卡星、哌拉西林/他唑巴坦、头孢他啶的敏感率分别为68.47%、66.30%、37.70%,并检出流感嗜血杆菌47株,其中对复方磺胺甲噁唑的敏感率为40.43%。ICU分离出的肠杆菌科细菌和非发酵细菌的耐药率均高于非ICU分离细菌;分离的细菌对亚胺培南和美罗培南的耐药情况较严重。结论加强细菌耐药率监测,有助于掌握其耐药特点,对临床指导用药的意义非常重要。
Objective To investigate the distribution and antimicrobial resistance of the common clinical specimens,and to provide evidence for the rational use of antibiotics.Methods All the bacterial strains i were analyzed,which were isolated from inpatients in Shanghai Baoshan Integrated Traditional Chinese and Western Medicine Hospital in 2016.Results were analyzed according to CLSI M100-S26,and WHONET5.6 software was used to analyze the drug resistance.Results A total of 1 920 clinical isolated strains were collected,of which gram negative bacteria and gram positive bacteria accounted for 72.14%（1 385/1 920）and 27.86%（535/1 920）.No Staphylococcal strains were found resistant to vancomycin and linezolid.Methicillin-resistant Staphylococcus aureus（MRSA）and Methicillin-resistant coagulase-negative Staphylococcus（MRCNS）accounted for 56.16% and 63.14%,respectively.The resistance rates of E.faeciumto most of the drugs tested were much higher than those of E.faecalis.One strain of E.faecium was found resistant to vancomycin.ESBLs were produced in 42.06%（106/252）of E.coli strains and 45.39%（143/315）of Klebsiella isolates,respectively.The resistant rates of ESBLs-producing strains were significantly higher than that of non-ESBLsproducing strains.More than 60% of the Acinetobacter baumannii strains were resistant to carbapenems.The percentages of Pseudomonas aeruginosa sensitive to amikacin,piperacillin-tazobactam and ceftazidime were 68.47%,66.30% and 37.70%,respectively.There were 47 strains of Haemophilus influezae,sensitive rate of which to Trimethoprim/sulfamethoxazole was found to be 40.43%.The drug resistance rates of Enterobacteriaceae and non-fermentative bacteria in ICU were generally higher than strains isolated from non-ICU.Conclusion It is very important to monitor the antibiotic resistance for better control of gram-positive infection and reasonable antibiotic use.
出处
《检验医学与临床》
CAS
2017年第23期3453-3457,3460,共6页
Laboratory Medicine and Clinic
基金
国家自然科学基金资助项目(81272603
81472179)
上海市第四轮公共卫生体系建设三年行动计划(15GWZK0301)
关键词
病原微生物
抗菌药物
灵敏度
耐药性
pathogenic microorganism
antibacterials
susceptibility
drug resistance
