2014年广东省惠州市某医院细菌耐药性分析

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目的了解广东省惠州市中大惠亚医院2014年临床分离的菌株对常见抗生素的耐药性。方法采用Vitek 2 Compact自动化仪器或Kirby-Bauer纸片法对临床分离菌株进行药物敏感试验,按照临床实验室标准化协会2014版标准判断结果,并用世界卫生组织NET 5.6软件进行统计分析。结果 2014年该院共收集患者分离菌株511株,其中革兰阴性菌306株,占59.9%,革兰阳性菌205株,占40.1%。金黄色葡萄球菌和凝固酶阴性葡萄球菌(CNS)中甲氧西林耐药株的检出率分别为38.9%和89.6%;粪肠球菌对所测试的抗生素的耐药率明显低于屎肠球菌;未检出对万古霉素、利奈唑胺耐药的革兰阳性球菌;大肠埃希菌和肺炎克雷伯菌的ESBLs检出率分别为53.9%和18.8%;肠杆菌科细菌中产ESBLs株对测试药物的耐药率普遍比非产ESBLs株高。铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的耐药率分别是20.7%和48.2%。嗜血杆菌的β内酰胺酶阳性率为18.5%。结论定期进行细菌耐药监测有助于了解细菌耐药的特征以及变迁,为临床合理用药提供依据。 Objective To understand the antibiotic resistance of clinically isolated strains in 2014 from Huida Hospital of Huizhou, Huizhou, Guangdong Province. Methods Vitek 2 Compact automated instrument or Kirby-Bauer paper method was used to carry out drug sensitivity test on clinical isolates. According to CLIA 2014 version, the results were judged and analyzed by WHO 5.6 software. Results A total of 511 isolates were collected from patients in this hospital in 2014, of which 306 were gram-negative bacteria, accounting for 59.9% and 205 were gram-positive bacteria, accounting for 40.1%. The detection rates of methicillin-resistant strains of Staphylococcus aureus and coagulase-negative staphylococci (CNS) were 38.9% and 89.6% respectively. The resistance rate of Enterococcus faecalis to antibiotics tested was significantly lower than that of Enterococcus faecium ; Gram positive cocci that resistant to vancomycin and linezolid were not detected; the detection rates of ESBLs of Escherichia coli and Klebsiella pneumoniae were 53.9% and 18.8% respectively; Enterobacteriaceae producing ESBLs strain Drug resistance rates to test drugs are generally higher than those of non-ESBLs-producing strains. The resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 20.7% and 48.2%, respectively. Haemophilus β-lactamase-positive rate of 18.5%. Conclusion Regular bacterial resistance monitoring can help to understand the characteristics and changes of bacterial resistance and provide the basis for clinical rational drug use.
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