摘要
目的了解2013-2016年重庆市血流感染病原菌的分布及耐药情况,为重庆市使用抗菌药物提供依据和参考。方法根据全国细菌耐药监测网技术要求,对血流感染分离菌进行鉴定和药敏试验,按照美国临床和实验室标准协会2016标准进行结果判读,用WHONET5.6软件对数据进行统计分析。结果 2013-2016年自血标本中共分离菌25 907株,其中革兰阳性菌10 612株,占41.0%;革兰阴性菌15 089株,占58.2%。居前5位的分离菌依次为大肠埃希菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌、金黄色葡萄球菌、肠球菌。产超广谱β-内酰胺酶(ESBL)的大肠埃希菌和肺炎克雷伯菌检出率分别为48.2%和26.0%;肺炎克雷伯菌对亚胺培南的耐药率为4.1%,非发酵菌表现为多重耐药。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为29.3%,未发现对万古霉素和利奈唑胺耐药的葡萄球菌。屎肠球菌除四环素外,其余药物耐药性均比粪肠球菌高,二者对万古霉素和利奈唑胺耐药率均<2.0%。结论重庆市血培养分离菌以革兰阴性菌为主,各分离菌株对常用抗菌药物的耐药性仍然较高。肺炎克雷伯菌对碳青霉烯类药物的耐药率有逐年增加的趋势,对指导重庆市规范有效地运用抗菌药物,做好耐药性监测意义重大。
Objective To investigate the distribution and drug resistance of pathogenic bacteria of blood stream infection in Chongqing from 2013 to 2016,and to provide evidence and reference for the use of antibiotics in Chongqing.Methods According to the technical requirements of national bacterial drug resistance monitoring network,the identification and drug sensitivity test of the isolated bacteria of blood flow infection was conducted,and the results were interpreted according to CLSI 2016 standard,and the data were statistically analyzed with the software WHONET 5.6.Results From 2013 to 2016,25 907 strains of isolated bacteria were isolated from blood samples,including 10 612 strains of gram-positive bacteria,which accounted for 41.0%,and the gram-negative bacteria were 15 089 strains,accounting for 58.2%.The bacteria in the top 5 were Escherichia coli,Coagulase-negative staphylococcus,Klebsiella pneumoniae,Staphylococcus aureus and Enterococcus.The detection rates of Escherichia coli and Klebsiella pneumoniae of ESBL were 48.2%and 26.0%respectively.The drug resistance rate of Klebsiella pneumoniae was 4.1%,and the non-fermentative bacteria showed multiple resistance.The detection rate of methicillin-resistant staphylococcus aureus(MRSA)was 29.3%,and the staphylococcus aureus was not found to be resistant to Vancomycin and Lynazolamide.In addition to Tetracycline,the drug resistance of other drugs was higher than that of Enterococcus faecalis,both of which were less than 2.0%.Conclusion Gram-negative bacteria were the main blood culture isolates in Chongqing,and the resistance of each isolate to commonly used antibiotics was still high.The resistance rate of Klebsiella pneumoniae to carbapenems is increasing year by year.It is of great significance to monitor the resistance of Klebsiella pneumoniae to carbapenems in order to guide the standard and effective use of antibiotics in Chongqing.
作者
廖云凤
严立
LIAO Yunfeng;YAN Li(Department of Clinical Laboratory,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《国际检验医学杂志》
CAS
2018年第21期2654-2661,2665,共9页
International Journal of Laboratory Medicine
基金
国家自然科学基金资助项目(81501834)
关键词
血培养
临床分离菌
耐药性监测
重庆
blood culture
clinical isolates
drug resistance surveillance
Chongqing
