摘要
目的分析2019年甘肃省医院标本中肺泡灌洗液临床分离菌的分布特点及其耐药性。方法收集甘肃省2019年1月-2019年12月74所医院中肺泡灌洗液(BALF)细菌的耐药监测资料,用药敏纸片扩散法、最低抑菌浓度(MIC)法和E试验法测定细菌对抗菌药物敏感性。结果甘肃省2019年BALF标本中纳入分析的细菌总数为1 043株,其中革兰阳性菌270株占比25.89%,革兰阴性菌773株占比74.11%,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)的检出率较高,且MRSA对抗菌药物的耐药率高于甲氧西林敏感金黄色葡萄球菌(MSSA),未发现对万古霉素、替考拉宁和利奈唑胺耐药的菌株。大肠埃希菌中超广谱β-内酰胺酶(ESBLs)的检出率高于肺炎克雷伯菌;鲍氏不动杆菌对碳青霉烯类的耐药率高于铜绿假单胞菌。结论甘肃省BALF标本分离病原菌以革兰阴性菌为主,耐药现状严重,对肺泡灌洗液细菌进行耐药性分析,有助于临床对各类肺部感染患者合理运用抗菌药物,以减少抗菌药物的滥用。
OBJECTIVE To investigate the distribution and drug resistance of clinical isolates from bronchoalveolar lavage fluid(BALF) specimens in Gansu Province in 2019. METHODS The data of surveillance of drug resistance of bacteria isolated from BALF were collected from 74 hospitals of Gansu Province from Jan 2019 to Dec 2019. The drug susceptibility of the strains was determined by using disk diffusion method, minimum inhibitory concentration((MIC)) method and E-test. RESULTS A total of 1 043 strains of bacteria that were isolated from BALF specimens were involved in the study in Gansu Province in 2019, 270(25.89%) of which were gram-positive bacteria, 773(74.11%) were gram-negative bacteria;the isolation rates of methicillin-resistant Staphylococcus aureus(MRSA) and methicillin-resistant coagulase-negative Staphylococcus(MRCNS) were relatively high. The drug resistance rates of MRSA strains were higher than those of methicillin-sensitive S.aureus(MSSA) strains. No vancomycin-, teicoplanin-or linezolid-resistant strains were found. The detection rate of extended-spectrum β-lactamases(ESBLs) was higher in Escherichia coli strains than in Klebsiella pneumoniae strains. The drug resistance rate of Acinetobacter baumannii strains to carbapenems was higher than that of Pseudomonas aeruginosa strains. CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from BALF specimens in Gansu Province, the drug resistance rates of the strains are high. The analysis of the drug resistance of the strains isolated from BALF may facilitate the reasonable use of antibiotics for the patients with different types of pulmonary infection so as to avoid the abuse of antibiotics.
作者
魏莲花
崔亚丽
张浩军
李可可
张映华
杨亚红
焦凤媛
王雯婕
关晓雯
刘萌
WEI Lian-hua;CUI Ya-li;ZHANG Hao-jun;LI Ke-ke;ZHANG Ying-hua;YANG Ya-hong;JIAO Feng-yuan;WANG Wen-jie;GUAN Xiao-wen;LIU Meng(Gansu Provincial Hospital,Lanzhou,Gansu 730000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第22期3402-3406,共5页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(81960385)。
关键词
肺泡灌洗液
细菌耐药
抗菌药物
Alveolar lavage fluid
Drug resistance of bacteria
Antibiotic
