摘要
目的探讨云南省无菌体液标本(不含血液)细菌的分布及耐药情况。方法选取2017年至2021年云南省9家三级综合医院无菌体液标本,排除同一患者重复株,使用WHONET5.6软件对药物敏感性数据进行统计分析。结果腹水是菌株分离率最高的标本类型,占32.7%。所有标本中共分离出5305株菌,革兰阳性菌占53.3%,分离率第一为表皮葡萄球菌;革兰阴性菌占46.7%,以大肠埃希菌为主。耐甲氧西林凝固酶阴性葡萄球菌和耐甲氧西林金黄色葡萄球菌耐药情况二者相当。屎肠球菌对于常用抗菌药耐药率呈下降的趋势。肺炎克雷伯菌对美罗培南和亚胺培南的耐药率分别为35.6%、40.3%,均高于2021年我国CHINET水平,且耐药率呈逐年升高的趋势。鲍曼不动杆菌仍保持耐多药的形式,尤其对碳青霉烯类药物耐药率高达82%。结论监测无菌体液病原菌来源广泛,不同菌属间碳青霉烯耐药形势严峻。仍需重点监测耐第三代头孢菌素的肠杆菌和耐碳青霉烯的肠杆菌、鲍曼不动杆菌。
Objective To explore the bacterial distribution and drug resistance of sterile body fluid specimens(excluding blood) in nine tertiary general hospitals in Yunnan Province from 2017-2021,and to provide a reference basis for the rational clinical use of antibiotics in the region. Methods Repeated strains from the same patients were excluded,and drug sensitivity tests were performed by instrumental method or paper method,and the results were interpreted according to the 2021 CLSI standard. Results Ascites was the specimen type with the highest strain isolation rate,accounting for 32.7%. A total of 5 305 strains were isolated from all specimens,with Gram-positive bacteria accounting for 53.3%, predominantly Staphylococcus epidermidis, and Gram-negative bacteria accounting for 46.7%, predominantly Escherichia coli. Methicillin-resistant coagulase-negative staphylococci and methicillin-resistant Staphylococcus aureus were comparable in both cases and should not be underestimated. Enterococcus faecalis showed a decreasing trend of resistance to commonly used antimicrobials. The resistance rates of Klebsiella pneumoniae to meropenem and imipenem were 35.6% and 40.3%,respectively,both of which were higher than the 2021 CHINET level,and the resistance rates showed a trend of increasing year by year. Acinetobacter baumannii was highly resistant to most antibiotics,especially to carbapenems with a resistance rate of 82%. Conclusion The source of pathogenic bacteria in sterile body fluid is extensive,and the form of carbapenem resistance among different genera is severe. It is still necessary to focus on monitoring the thirdgeneration cephalosporin-resistant Enterobacteriaceae and carbapenem-resistant Enterobacteriaceae and Acinetobacter baumannii.
作者
李洁
何媛
吴春燕
单斌
郑瑞
管志福
任宝军
师春霞
周友全
刘涵禹
张米
康燕明
宋贵波
LI Jie;HE Yuan;WU Chunyan;SHAN Bin;ZHENG Rui;GUAN Zhifu;REN Baojun;SHI Chunxia;ZHOU Youquan;LIU Hanyu;ZHANG Mi;KANG Yanming;SONG Guibo(Dept.of Clinical Laboratory,The 1st Affiliated Hospital of Kunming Medical University;Yunnan Key Laboratory of Laboratory Medicine;Yunnan Province Clinical Research Center for Laboratory Medicine,Kunming Yunnan 650032;Dept.of Clinical Laboratory,The First People’s Hospital of Yunnan Province,Kunming Yunnan 650034;Dept.of Clinical Laboratory,Xishuangbanna Dai Autonomous Prefecture People’s Hospital,Xishuangbanna Yunnan 666100;Dept.of Clinical Laboratory,The First People’s Hospital of Kunming,Kunming Yunnan 650200;Dept.of Clinical Laboratory,Dali Bai Autonomous Prefecture People’s Hospital,Dali Yunnan 671000;Dept.of Clinical Laboratory,Yunnan Cancer Hospital,Kunming Yunnan,650032;Dept.of Clinical Laboratory,Yunnan Traditional Chinese Medicine Hospital,Kunming Yunnan 650188;Dept.of Clinical Laboratory,Yunnan Provincial Hospital of Infectious Diseases,Kunming Yunnan 650300;Dept.of Clinical Laboratory,Nujiang Lisu Autonomous Prefecture People’s Hospital,Lushui Yunnan 673100,China)
出处
《昆明医科大学学报》
CAS
2023年第3期61-67,共7页
Journal of Kunming Medical University
基金
科技部科技基础资源调查专项项目(2019FY101200,2019FY101209)
云南省“高层次人才培养支持计划”青年拔尖人才项目(YNWR-QNBJ-2020-261)
云南省医学学科后备人才项目(H-2018075)。
关键词
无菌体液
病原菌
耐药性
Sterile body fluids
Pathogenic bacteria
Drug resistance
