2019年上海市东方医院细菌耐药性监测

目的了解2019年上海市东方医院(南院)菌株分布和抗菌药物敏感性。方法用纸片扩散法(K-B法)测量抗菌药物抑菌圈直径,梅里埃自动化仪器检测最低抑菌浓度(MIC),按照美国临床实验室标准化协会(CLSI)指南M1002020版和美国食品和药物管理局(FDA)标准判断结果,用WHONET 5.6软件对本院分离细菌耐药性进行统计分析。结果分离非重复菌株共1510株,革兰阳性菌(G+菌)487株,占32.25%;革兰阴性菌(G-菌)1023株,占67.75%。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80.0%和54.1%。发现1株利奈唑胺耐药的粪肠球菌。β溶血链球菌以无乳链球菌为主,占77.1%,而无乳链球菌对青霉素96.3%敏感。肺炎链球菌均来自成年人的痰液,50%对青霉素敏感。大肠埃希菌和肺炎克雷伯菌超广谱β内酰胺酶(ESBLs)阳性率分别为52.6%和61.0%。耐碳青霉烯类肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌和铜绿假单胞菌检出率分别为53.1%,2.2%,91.1%和38.1%。结论本院细菌耐药率高,应加强及重视细菌耐药监测。

Bacterial resistance reported from south of Shanghai East Hospital in 2019

Objective To investigate the distribution and antibiotic susceptibility of clinically isolated bacteria in the South Hospital of Shanghai East Hospital in 2019.Methods The Kirby-Bauer method(K-B method)was used to measure the inhibition zone of antibacterial drugs,and the minimum inhibitory concentration(MIC)was detected by BioMérieux automatic instrument.Results were interpreted according to the breakpoints of Clinical and Laboratory Standards Institute(CLSI)and Food and Drug Administration(FDA),and analyzed by software WHONET5.6.Results A total of 1510 non-duplicate strains were isolated in 2019,including 487(32.25%)gram-positive(G^+)bacteria and 1023(67.75%)gram-negative(G^-)bacteria.Methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococci(MRCNS)accounted for 54.1%and 80.0%,respectively.One strain of linezolid-resistant Enterococcus faecalis was found.Streptococcusβ-hemolyticus is mainly Streptococcus agalactiae,accounting for 77.1%.Streptococcus agalactiae is 96.3%sensitive to penicillin.Streptococcus pneumoniae were all from the sputum of adults,and 50%of the isolates are penicillin-sensitive.The positive extended-spectrumβ-lactamases(ESBLs)rates of Escherichia coli and Klebsiella pneumoniae were 52.6%and 61.0%,respectively.Carbapenem-resistant Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii and Pseudomonas aeruginosa accounted for 53.1%,2.2%,38.1%and 91.1%,respectively.Conclusion The rate of bacterial drug resistance in this hospital is serious.It is necessary to pay attention to the monitoring of bacterial resistance.