2012年至2015年烟台某医院细菌分布及耐药性分析
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摘要
目的了解2012年至2015年烟台某医院的细菌分布及耐药情况,为临床合理选用抗菌药物提供依据。方法采用VITEK 2 Compact全自动细菌分析系统或纸片扩散法(K-B法)进行药物敏感性试验并统计耐药率,采用WHONET 5.6软件分析数据。结果 2012年至2015年共分离出26 499株细菌,最常见的前5种为大肠埃希菌、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,其中前3种细菌对头孢哌酮舒巴坦、哌拉西林他唑巴坦、阿米卡星耐药率低,鲍曼不动杆菌仅对头孢哌酮舒巴坦耐药率低,未发现对万古霉素、利奈唑胺、替加环素耐药的金黄色葡萄球菌;主要病原菌(鲍曼不动杆菌除外)对抗菌药物的耐药率呈逐年下降趋势。结论动态监测地区的细菌耐药变迁,对指导临床合理选用抗菌药物和降低细菌耐药率有重要指导意义。
Objective To understand the distribution and drug resistance of bacteria from 2012 to 2015 in a hospital in Yantai,so as to provide a basis for the rational use of antibacterials in clinical. Methods Drug sensitivity tests were tested by VITEK2 Compact or disk diffusion method(K-B method). The data was analyzed by WHONET 5. 6 statistical software. Results A total of 26 499 clinical isolates were collected,the top 5 pathogenic bacteria were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and S taphylococcus aureus. The resistance rates of the first 3 types of bacteria to cefperazone-sulbactam,piperacillin-tazobactam and amikacin were lower. The strains of Acinetobacter baumannii were only lowest to cefoperazone-sulbactam. No Staphylococcus aureus was found to be resistant to vancomycin, linezolid and tegocycline. The antibiotic resistance of major bacteria shows downtrend of year after year(except Acinetobacter baumannii). Conclusion Dynamic monitoring of bacterial resistance changes in the region has important significance for guiding the rational selection of antibacterials and reducing the rate of bacterial resistance.
Objective To understand the distribution and drug resistance of bacteria from 2012 to 2015 in a hospital in Yantai,so as to provide a basis for the rational use of antibacterials in clinical. Methods Drug sensitivity tests were tested by VITEK2 Compact or disk diffusion method(K-B method). The data was analyzed by WHONET 5. 6 statistical software. Results A total of 26 499 clinical isolates were collected,the top 5 pathogenic bacteria were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and S taphylococcus aureus. The resistance rates of the first 3 types of bacteria to cefperazone-sulbactam,piperacillin-tazobactam and amikacin were lower. The strains of Acinetobacter baumannii were only lowest to cefoperazone-sulbactam. No Staphylococcus aureus was found to be resistant to vancomycin, linezolid and tegocycline. The antibiotic resistance of major bacteria shows downtrend of year after year(except Acinetobacter baumannii). Conclusion Dynamic monitoring of bacterial resistance changes in the region has important significance for guiding the rational selection of antibacterials and reducing the rate of bacterial resistance.
引文
[1]汪复,朱德妹,胡付品,等.2012年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2013,13(5):321-330.
[2]胡付品,朱德妹,汪复,等.2013年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2014,14(5):365-374.
[3]胡付品,朱德妹,汪复,等.2014年CHINET中国细菌耐药性监测[J].中国感染与化疗杂志,2015,15(5):401-410.
[4]胡付品,朱德妹,汪复,等.2015年CHINET细菌耐药性监测[J].中国感染与化疗杂志,2016,16(6):685-694.
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[7]中华医学会呼吸病学分会.社区获得性肺炎诊断和治疗指南[J].中华结核和呼吸杂志,2006,29(10):651-655.
[8]孙敬,陈会,余理智,等.痰液培养定植菌与病原菌判断方法的探讨[J].江西医学检验,2006,24(6):485-488.
[9]周华,李光辉,陈佰义,等.中国产超广谱β-内酰胺酶肠杆菌科细菌感染应对策略专家共识[J].中华医学杂志,2014,94(24):1847-1856.
[10]Peleg AY,Seifert H,Paterson DL.Acinetoba cter bauma nnii:emergence of a successful pathogen[J].Clin Microbiol Rev,2008,21(3):538-582.
[11]Fishbain J,Peleg AY.Treatment of Acinetobacter infections[J].Clin Infect Dis,2010,51(1):79-84.
[12]Garnacho-Montero J,Amaya-Villar R.Multiresistant Acinetoba cter baumannii infections:epidemiology and management[J].Curr Opin Infect Dis,2010,23(4):332-339.
[13]陈佰义,何礼贤,胡必杰,等.中国鲍曼不动杆菌感染诊治与防控专家共识[J].中华医学杂志,2012,92(2):76-83.
[14]张波,吕晓,朱武,等.2012-2015年肠球菌属临床感染及耐药性变迁[J].中华医院感染学杂志,2017,27(1):47-50.
[15]李金钟.肠球菌分类与鉴定新进展[J].临床检验杂志,2006,24(3):228-230.
[2]胡付品,朱德妹,汪复,等.2013年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2014,14(5):365-374.
[3]胡付品,朱德妹,汪复,等.2014年CHINET中国细菌耐药性监测[J].中国感染与化疗杂志,2015,15(5):401-410.
[4]胡付品,朱德妹,汪复,等.2015年CHINET细菌耐药性监测[J].中国感染与化疗杂志,2016,16(6):685-694.
[5]朱水龙.重症监护室多重耐药菌的耐药性检测分析[J].中国药业,2012,21(22):48-49.
[6]史秋亚,王红举,周卜全.2010年医院重症监护室细菌感染监测与分析[J].中国药业,2012,21(11):16-18.
[7]中华医学会呼吸病学分会.社区获得性肺炎诊断和治疗指南[J].中华结核和呼吸杂志,2006,29(10):651-655.
[8]孙敬,陈会,余理智,等.痰液培养定植菌与病原菌判断方法的探讨[J].江西医学检验,2006,24(6):485-488.
[9]周华,李光辉,陈佰义,等.中国产超广谱β-内酰胺酶肠杆菌科细菌感染应对策略专家共识[J].中华医学杂志,2014,94(24):1847-1856.
[10]Peleg AY,Seifert H,Paterson DL.Acinetoba cter bauma nnii:emergence of a successful pathogen[J].Clin Microbiol Rev,2008,21(3):538-582.
[11]Fishbain J,Peleg AY.Treatment of Acinetobacter infections[J].Clin Infect Dis,2010,51(1):79-84.
[12]Garnacho-Montero J,Amaya-Villar R.Multiresistant Acinetoba cter baumannii infections:epidemiology and management[J].Curr Opin Infect Dis,2010,23(4):332-339.
[13]陈佰义,何礼贤,胡必杰,等.中国鲍曼不动杆菌感染诊治与防控专家共识[J].中华医学杂志,2012,92(2):76-83.
[14]张波,吕晓,朱武,等.2012-2015年肠球菌属临床感染及耐药性变迁[J].中华医院感染学杂志,2017,27(1):47-50.
[15]李金钟.肠球菌分类与鉴定新进展[J].临床检验杂志,2006,24(3):228-230.