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目的了解新疆地区临床分离株对常用抗菌药物的敏感性和耐药性。方法按标准纳入分析共23家医院的临床分离菌,采用标准纸片扩散法或自动化仪器检测法,按照统一技术方案进行细菌药物敏感性试验,依据CLSI 2014年标准判断结果。结果共收集细菌65488株,其中革兰阳性菌共19976株,占30.5%,革兰阴性菌45512株,占69.5%。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)的检出率分别为23.97%和77.83%,自2012年起呈下降趋势。粪肠球菌对多数抗菌药物的耐药率均显著低于屎肠球菌,两者中均有少数万古霉素耐药株。青霉素耐药的肺炎链球菌儿童和成人患者比例分别占0.6%和1.2%。革兰阴性菌中分离率前3位分别为大肠埃希菌15678株(23.9%)、肺炎克雷伯菌10334株(15.8%)和鲍曼不动杆菌6198株(9.5%),大肠埃希菌、克雷伯菌属以及奇异变形菌产ESBL菌株分别占31.12%、26.33%和9.77%,鲍曼不动杆菌的检出率高于铜绿假单胞菌,其对亚胺培南和美罗培南的耐药率分别为51.7%和56.3%。自2012年起呈上升趋势。碳青霉烯类耐药的肺炎克雷伯菌检出率有所上升。结论新疆地区耐碳青霉烯类肠杆菌科细菌(CRE)及鲍曼不动杆菌对碳青霉烯类的耐药率仍呈上升趋势,给临床的抗感染治疗带来极大挑战。
Objective To understand the sensitivity and drug resistance of clinical isolates to commonly used antibiotics in Xinjiang. Methods A total of 23 clinical isolates from hospitals were included in the analysis according to the standard. Bacterial drug susceptibility tests were conducted according to a uniform technical protocol using the standard disk diffusion method or automated instrument detection method. Results were judged according to the CLSI 2014 standard. Results A total of 65488 bacterial strains were collected, of which 19976 were Gram-positive bacteria, accounting for 30.5%, 45512 Gram-negative bacteria, accounting for 69.5%. The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus (MRCNS) were 23.97% and 77.83%, respectively, showing a decreasing trend since 2012. Enterococcus faecalis resistance to most antibiotics were significantly lower than Enterococcus faecium, both of which have a few vancomycin-resistant strains. The proportion of penicillin-resistant Streptococcus pneumoniae children and adults accounted for 0.6% and 1.2% respectively. The first three isolates of Gram-negative bacteria were Escherichia coli 15678 (23.9%), Klebsiella pneumoniae 10334 (15.8%) and Acinetobacter baumannii 6198 (9.5%), Escherichia coli The strains of ESBL producing Klebsiella and S. mirabilis accounted for 31.12%, 26.33% and 9.77%, respectively. The detection rate of Acinetobacter baumannii was higher than that of Pseudomonas aeruginosa, The resistance rates were 51.7% and 56.3% respectively. It has been on the rise since 2012. The detection rate of carbapenem-resistant Klebsiella pneumoniae increased. Conclusion The resistance rates of carbapenem-resistant strains of carbapenem-resistant bacteria (CRE) and Acinetobacter baumannii in Xinjiang are still on the rise, posing a great challenge to clinical anti-infective therapy.