2019年内蒙古包头市细菌耐药监测

目的 监测2019年包头市11所三级医院所有临床分离菌株的构成及对常用抗菌药物的耐药情况，为临床科室选择抗菌药物提供可靠依据。方法 对上述医院的临床分离菌采用纸片扩散法（KB法）或全自动药敏仪法进行药敏试验，按CLSI 2018年版 M - 100标准判读药敏结果，采用WHONET 2019软件进行数据分析。结果 2019年共收集上述医院非重复临床分离菌8 430株，其中革兰阳性菌2 278株，占比27.0%，革兰阴性菌6 152株，占比73.0%。葡萄球菌属中耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）和耐甲氧西林金黄色葡萄球菌 (MRSA）检出率分别为65.5%和12.8%，未检出利奈唑胺、万古霉素和替考拉宁耐药菌株。粪肠球菌（EFA）对多数抗菌药物的耐药率均低于屎肠球菌（EFM），EFA中检出2株利奈唑胺耐药菌株，EFM中检出1株替考拉宁耐药菌株、2株万古霉素耐药菌株。产超广谱β- 内酰胺酶（ESBLs）大肠埃希菌（ECO）和ESBLs（+）克雷伯菌属菌株的检出率分别为46.0%和16.8%。耐碳青霉烯大肠埃希菌（CREC）和耐碳青霉烯肺炎克雷伯菌（CRKP） 的检出率分别为0.5%和1.1%，CREC对左旋氧氟沙星的耐药率为100%，远高于CRKP的29.4%。结论 本地区ECO对喹诺酮类抗菌药物耐药率较高，应继续做好耐药监测工作，加强抗菌药物的合理使用，预防耐药菌的产生与传播。

Surveillance of antimicrobial resistance in Baotou,Inner Mongolia in 2019

To monitor the composition of all clinical isolates and their resistance to commonly used antibiotics in 11 tertiary hospitals in Baotou, Inner Mongolia in 2019, so as to provide a reliable basis for clinical departments to select antibiotics. Methods The drug sensitivity test of clinical isolates from the above hospitals was carried out by disk diffusion method(KB method) or automatic drug sensitivity test. The drug sensitivity results were read according to the CLSI2018 M-100, and the data were analyzed by WHONET 2019. Results A total of 8 430 strains of non-repetitive clinical isolates from the above hospitals were collected in 2019, including 2 278 Gram-positive bacteria, accounting for 27.0%, and 6 152 Gramnegative bacteria, accounting for 73.0%. The detection rates of methicillin-resistant strains(MRCNS and MRSA) of coagulasenegative staphylococci and staphylococcus aureus were 65.5% and 12.8%, respectively. Linezolide, vancomycin and teicoplanin resistant strains were not detected in staphylococci. The resistance rate of Enterococcus faecalis to most antibiotics was lower than that of Enterococcus faecium. Two strains resistant to linezolid were detected in Enterococcus faecalis, and one strain resistant to teicoplanin and two strains resistant to vancomycin were detected in Enterococcus faecium. The detection rates of Escherichia coli and Klebsiella producing ESBLs strains were 46.0% and 16.8%, respectively.The detection rates of CREC and CRKP were 0.5% and 1.1%, respectively. The resistance rate of CREC to levofloxacin was 100%, much higher than 29.4% of CRKP. Conclusion The ECO in this area has a relatively high rate of resistance to quinolone antimicrobial drugs. Drug resistance monitoring should be continued, and antimicrobial drugs should be used in a sensible way, so as to prevent the emergence and spread of drug-resistant bacteria.