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目的对2013-2015年某结核病专科医院临床分离病原菌进行分析,了解病原菌分布特点及耐药性。方法采用VITEK2-compact检测系统对分离的细菌进行鉴定和药敏实验。采用WHONET5.6软件对细菌鉴定及药敏实验结果进行分析。结果共检出革兰阴性菌2 991株,占90.4%,革兰阳性菌317株,占9.6%。连续3年检出率居前三位的病原菌依次为肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌。2013-2015年,产超广谱β内酰胺酶(ESBLs)大肠埃希菌检出率分别为40.4%、48.2%和38.3%,产ESBLs肺炎克雷伯菌检出率分别为16.9%、8.4%和11.6%。未检出亚安培南耐药大肠埃希菌。肺炎克雷伯菌对亚安培南的耐药率平均为1.6%。甲氧西林耐药金黄色葡萄球菌(MRSA)检出率分别为53.8%、54.3%、42.9%。甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)检出率分别为84.5%、82.7%、85.9%。未检出万古霉素、利奈唑胺、替加环素耐药葡萄球菌。肠球菌对庆大霉素、利奈唑胺、替加环素、万古霉素比较敏感。结论碳青霉烯类抗菌药是抗肠杆菌科细菌最有效药物。万古霉素、利奈唑胺和替加环素是抗葡萄球菌较好的药物。肺炎克雷伯菌、鲍曼不动杆菌检出率逐年上升。需加强耐药监测以控制多药耐药菌的传播。
Objective To analyze the clinical isolates of pathogenic bacteria from a TB hospital from 2013 to 2015 to understand the distribution characteristics and drug resistance of pathogens. Methods VITEK2-compact detection system was used to identify the bacteria isolated and susceptibility testing. WHONET5.6 software was used to analyze the bacterial identification and drug susceptibility test results. Results A total of 2 991 strains of Gram-negative bacteria were detected, accounting for 90.4% and 317 strains of Gram-positive bacteria, accounting for 9.6%. The top three pathogens detected in three consecutive years were Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii. The detection rates of Escherichia coli producing extended-spectrum β-lactamases (ESBLs) were 40.4%, 48.2% and 38.3% respectively from 2013 to 2015. The detection rates of Klebsiella pneumoniae producing ESBLs were 16.9% and 8.4% respectively % And 11.6%. No detectable amoxicillin resistance in southern Asia. Klebsiella pneumoniae resistant to amnanopan in an average rate of 1.6%. The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) were 53.8%, 54.3% and 42.9%, respectively. The detection rates of methicillin-resistant coagulase-negative staphylococci (MRCNS) were 84.5%, 82.7% and 85.9%, respectively. No vancomycin, linezolid, tigecycline-resistant staphylococci were detected. Enterococci gentamicin, linezolid, tigecycline, vancomycin more sensitive. Conclusion Carbapenems antibacterials are the most effective drugs against Enterobacteriaceae. Vancomycin, linezolid and tigecycline are better anti-staphylococcal drugs. Klebsiella pneumoniae, Acinetobacter baumannii detection rate increased year by year. Drug resistance surveillance needs to be strengthened to control the spread of multidrug-resistant bacteria.