2011年湘雅医院临床分离病原菌分布及耐药性分析

目的了解2011年中南大学湘雅医院临床常见分离菌的分布及耐药性,为临床合理使用抗菌药物提供依据。方法采用全自动微生物鉴定系统Vitek-2对临床分离病原菌进行鉴定及药敏试验,用WHONET5.4软件对实验结果进行分析。结果 2011年湘雅医院共分离菌株7 272株,其中革兰阳性菌2 85株,占28.67%;革兰阴性菌4 109株,占56.51%;真菌1 078株,占14.82%。葡萄菌属中耐甲氧西林金黄葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRSCN)的检出率分别为51.37%和68.16%,未检出对万古霉素、替考拉宁及利奈唑胺耐药株;屎肠球菌和粪肠球菌对万古霉素的耐药率分别均为3.91%和3.83%;大肠埃希菌和肺炎克雷伯菌中超广谱β-内酰胺酶(ESBLs)的检出率分别为78.30%和63.10%,肠杆菌科细菌对碳青霉烯类抗菌药物仍高度敏感(耐药率<6.00%),首次监测到泛耐药肠杆菌科细菌;与2010年相比,铜绿假单胞菌和鲍曼不动杆菌中泛耐药株数显著增加。结论临床分离病原菌以革兰阴性杆菌为主;分离菌株耐药性十分严重;泛耐药肠杆菌科细菌的出现及泛耐药非发酵革兰阴性杆菌的增加,应引起临床高度重视,并及时采取防控措施。

Analysis of the distribution and antibiotic resistance of pathogenic bacteria from Xiangya Hospital in 2011

Objectives To investigate the distribution and antibiotic resistance of clinical isolates from Xiangya Hospital of Central South University in 2011 and to provide criteria for the rational use of antibiotics by clinics.Methods Isolates were identified and antimicrobial susceptibility testing was carried out using the Vitek-2 automated microorganism identification system.Data were analyzed using WHONET 5.4 software.Results Of 7 272 isolates collected from Xiangya Hospital in 2011,285(28.67%) were Gram-positive bacteria,4 109(56.51%) were Gram-negative bacteria,1078(14.82%) were fungi.Among the Staphylococcus isolates,51.37% were MRSA and 68.16% were MRSCN.No vancomycin,teicoplanin,or linezolid-resistant strains were noted.Enterococcus faecium and Enterococcus faecalis were resistant to vancomycin at a rate of 3.91% and 3.83%,respectively.ESBLs were detected in 78.30% of Escherichia coli and 63.10% of Klebsiella pneumoniae.Enterobacteriaceae remained highly sensitive to carbapenem antibiotics(resistance rate <6.00%),and a few pan-resistant Enterobacteriaceae were detected for the first time.The proportion of pan-resistant strains of Pseudomonas aeruginosa and Acinetobacter baumannii increased significantly in comparison to the proportion in 2010.Conclusion Most clinical isolates from this hospital were Gram-negative bacilli.Clinical isolates had extensive antibiotic resistance.Pan-resistant Enterobacteriaceae and pan-resistant non-fermenting Gram-negative bacteria are increasing.These developments warrant close scrutiny and effective control measures should be taken.