不同标本中5种重要病原菌的耐药性监测

目的分析滁州市第一人民医院2019年临床分离菌对抗菌药物的耐药率,比较同种细菌不同标本来源菌株间的耐药率差异。方法使用VITEK 2Compact对滁州市第一人民医院2019年临床分离菌进行鉴定和药敏试验,使用WHONET5.6软件对药敏结果进行统计分析。结果 2019年共分离细菌4 374株,其中革兰阳性菌1 196株(27.3%),革兰阴性菌3 178株(72.7%)。菌株主要分离自下呼吸道标本(49.6%)、尿液(25.8%)、分泌物(9.3%)和血液(10.3%),5种重要病原菌在这4种标本中的分离率分别为75.0%、56.7%、52.2%和44.7%。在这4种标本中,耐甲氧西林金黄色葡萄球菌(MRSA)的检出率分别为47.4%、25.0%、26.4%和37.7%,葡萄球菌中未见万古霉素耐药株。大肠埃希菌对替加环素全敏感,对碳青霉烯类抗菌药物的耐药率均小于5.0%。肺炎克雷伯菌对碳青霉烯类抗菌药物均有不同程度的耐药,其中尿液中的分离株,对其耐药率达到23.0%。肠杆菌科细菌对碳青霉烯类抗菌药物敏感率仍然较高,耐碳青霉烯类肠杆菌科细菌(CRE)的检出率为7.0%,其中耐碳青霉烯类肺炎克雷伯菌的检出率为14.0%。铜绿假单胞菌在下呼吸道标本中对碳青霉烯类抗菌药物的耐药率为24.0%;在血标本和分泌物标本中,对碳青霉烯类抗菌药物的耐药率为0.0%。鲍曼不动杆菌对碳青霉烯类抗菌药物的耐药率较高,除尿夜标本分离的鲍曼不动杆菌外,其余均大40.0%。结论 5种重要病原菌对抗菌药物均有不同程度的耐药,尤其是耐碳青霉烯类肺炎克雷伯菌检出率仍然较高,给临床抗感染治疗带来极大困难。

Drug resistance monitoring of five important pathogens in different specimens

Objective To analyze the resistance rates of clinically isolated bacteria to antibacterial drugs in the Chuzhou Municipal First People′s Hospital during 2019 and to compare the differences in the drug resistance rates among the strains of same species of bacterium from different specimen sources.Methods The bacterial identification and drug susceptibility tests on the clinically isolated bacteria in this hospital during 2019 were performed by the VITEK 2 Compact bacterial identification system.The results of drug susceptibility test were analyzed by using the WHONET 5.6 software.Results A total of 4374 strains of bacteria were isolated during 2019,including 1196 strains(27.3%)of Gram-positive bacteria and 3178 strains(72.7%)of Gram-negative bacteria.The pathogenic bacterial strains were mainly isolated from the lower respiratory tract samples(49.6%),urine(25.8%),secretion(9.3%)and blood(10.3%).The isolation rates of 5 important pathogenic bacteria in these 4 kinds of samples were 75.0%,56.7%,52.2%and 44.7%respectively.In the four specimens,the detection rates of methicillin resistant Stapylococcus aureus(MRSA)were 47.4%,25.0%,26.4%and 37.7%,respectively.No vancomycin resistant strain in staphylococcus was found.Escherichia coli was fully sensitive to tigecycline and its resistance rate to carbapenem antibacterial drugs was less than 5.0%.Klebsiella pneumoniae had different degrees of resistance to carbapenem antibacterial drugs,and the resistance rate of isolated strains from urine reached 23.0%.Enterobacteriaceae bacterria were still highly susceptible to carbapenem antibacterial drugs.The detection rate of carbapenem-resistant Enterobacteriaceae(CRE)was 7.0%,in which the detection rate of carbapenem-resistant K.pneumoniae was 14.0%.The resistance rate of Pseudomonas aeruginosa in the lower respiratory tract sample to carbapenems was 24.0%,which in the blood and secretion samples were 0.0%.The resistance rate of Acinetobacter baumannii to carbapenem antibacterial drugs was high.Except for A.baumannii isolated from urine samples,the rests were greater than 40.0%.Conclusion The five important pathogenic bacteria have different degrees of resistance to antibacterial drugs,especially the detection rate of carbapenem-resistant Klebsiella pneumoniae is still high,which brings great difficulties to clinical anti-infective treatment.