丽水市中心医院2017年临床分离菌耐药情况

目的 了解2017年丽水市中心医院临床分离病原菌的分布情况和耐药特征。方法 收集丽水市中心医院2017年全年临床分离病原菌，采用K-B纸片法及Vitek2-Compact系统进行药物敏感性试验，采用WHONET 5.6软件进行数据分析。结果 共分离到病原菌5 928株，其中革兰阳性菌1 875株（31.63%），革兰阴性菌4 053株（68.37%）。革兰阳性菌中以金黄色葡萄球菌、凝固酶阴性葡萄球菌、屎肠球菌、粪肠球菌、肺炎链球菌为多见。革兰阴性菌中以大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、流感嗜血杆菌为多见。肠杆菌科细菌对碳青霉烯类抗菌药、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢西丁敏感性较高。产超广谱β内酰胺酶大肠埃希菌和肺炎克雷伯菌的检出率分别为53.5%和23.6%。鲍曼不动杆菌复合群对碳青霉烯类抗菌药、喹诺酮类、头孢吡肟的耐药率>70%。铜绿假单胞菌对阿米卡星、头孢他啶、头孢吡肟、哌拉西林/他唑巴坦的耐药率30%，未检到万古霉素和利奈唑胺的耐药株。耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌的检出率分别为43.6%和68.5%。结论 细菌耐药情况日益严重，特别是多重耐药及泛耐药细菌的不断增加给临床治疗带来了极大的困难，因此须定期监测细菌耐药情况以预防耐药菌的产生和传播流行。

Distribution and drug-resistance of common clinical bacteria in Lishui Central Hospital in 2017

Abstract: Objective To analyze the distribution and drug-resistance of clinical isolates in Lishui Central Hospital in 2017. Methods Clinical isolates during the year 2017 were collected; the antibiotic sensitivity was tested with Kirby-Bauer method and Vitek2-Compact system; all the data were analysed by using WHONET 5.6 software. Results 5,928 strains were collected, among which Gram-positive bacteria accounted for 31.63%, including Staphylococcus aureus, coagulase negative staphylococcus, Enterococcus faecium, Enterococcus faecalis and Streptococcus pneumoniae while Gram-negative bacteria accounted for 68.37%, including Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Haemophilus influenzae. Enterobacteriaceae were more susceptible to Carbapenems, Cefoperazone/Sulbactam, Piperacillin/Tazobactam and Cefoxitin. The detection rates of extended spectrum beta lactamase producing Escherichia coli and Klebsiella pneumoniae were 53.5% and 23.6% respectively. The resistance rates of Acinetobacter baumannii complex group to Carbapenems, Quinolones and Cefepime were >70% respectively, and the resistance rates of Pseudomonas aeruginosa to Amikacin, Ceftazidime, Cefepime and Piperacillin/Tazobactam were <15%. The resistance rates of Staphylococcus to Quinolones, Erythromycin and Tetracycline were >30%. Vancomycin and Linezolid resistant strains were not detected. The detection rates of methicillin resistant Staphylococcus aureus and coagulase negative Staphylococcus were 43.6% and 68.5% respectively. Conclusion Bacterial resistance is becoming higher, especially the increase of multidrug-resistant and extensively-resistant bacteria, which presents serious challenge to clinical treatment. Therefore, bacterial resistance must be monitored regularly so as to prevent the emergence and spread of drug-resistant strains.