某医院2013-2017年细菌耐药性趋势分析

目的分析医院2013-2017年临床常见分离菌对抗菌药物的耐药特点及变迁趋势,为临床合理使用抗菌药物提供参考依据。方法采用VITEK-2 Compact全自动细菌鉴定仪进行菌科鉴定,纸片扩散(K-B)法测定细菌对受试抗菌药物的敏感性,使用WHONET 5.6软件收集耐药性数据,分析临床常见分离菌的耐药特点。结果2013-2017年大肠埃希菌占比始终位于首位,鲍曼不动杆菌占比明显下降,肺炎克雷伯菌、屎肠球菌和粪肠球菌占比有所上升。大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、金黄色葡萄球菌耐药率主要呈下降趋势,肠球菌耐药率处于波动中;其中大肠埃希菌耐药率普遍高于肺炎克雷伯菌,鲍曼不动杆菌耐药率普遍高于铜绿假单胞菌,屎肠球菌对多数抗菌药物耐药率高于粪肠球菌。结论肠球菌耐药率控制效果不佳,临床应进一步发挥抗菌药物科学化管理团队的作用,促进抗菌药物合理使用,延缓细菌耐药。

Trend analysis of bacterial resistance in a hospital in recent 2013-2017 years

Objective To analyze the drug resistance characteristics and change trend of common clinical isolates to antibacterials from 2013 to 2017 in order to provide reference for rational use of antibacterials.Methods The VITEK-2 Compact automatic bacterial identification instrument was used to identify the bacteria and the susceptibility of the bacteria to the tested antibiotics was determined by the K-B method.Drug resistance data was collected by WHONET 5.6 software and the drug resistance characteristics of common clinical isolates were analyzed.Results From 2013 to 2017,the proportion of Escherichia coli was always in the first place,the proportion of Acinetobacter baumannii decreased significantly,and the proportion of Klebsiella pneumoniae,Enterococcus faecium and Enterococcus faecalis increased.The drug resistance rate of Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii and Staphylococcus aureus decreased,while the drug resistance rate of Enterococcus fluctuated;among them,the resistance rate of Escherichia coli was generally higher than Klebsiella pneumoniae,the resistance rate of Acinetobacter baumannii to most antibacterials was generally higher than the Pseudomonas aeruginosa,and that of Enterococcus faecium is higher than the Enterococcus faecalis.Conclusion The control effect of drug resistance rate of enterococcus is not good,so the clinical should further play the role of scientific management team of antibacterials,promote the rational use of antibacterials,and delay bacterial drug resistance.