本文選題：耐藥性監(jiān)測(cè) + 抗菌藥物�。� 參考：《中國(guó)抗生素雜志》2016年05期

【摘要】：目的了解南昌大學(xué)第二附屬醫(yī)院2014年臨床分離菌對(duì)常用抗菌藥物的敏感性和耐藥性。方法收集我院2014年1月1日至12月31日非重復(fù)臨床分離株,采用紙片擴(kuò)散法或自動(dòng)化儀器法進(jìn)行藥物敏感性試驗(yàn)。按美國(guó)臨床實(shí)驗(yàn)室標(biāo)準(zhǔn)化協(xié)會(huì)(CLSI)2014年版標(biāo)準(zhǔn)判斷結(jié)果,WHONET 5.5軟件進(jìn)行耐藥性分析。結(jié)果共收集非重復(fù)臨床分離菌4034株,其中革蘭陽(yáng)性菌1263株,占31.3%,革蘭陰性菌2771株,占68.7%。耐甲氧西林金黃色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)和耐甲氧西林凝固酶陰性葡萄球菌(methicillin-resistant coagulase-negative Staphylococcus,MRCNS)檢出率分別為25.8%和79.9%。未發(fā)現(xiàn)利奈唑胺和萬(wàn)古霉素耐藥株。90.4%MRSA對(duì)復(fù)方磺胺甲VA唑敏感,80.3%MRCNS對(duì)利福平敏感。糞腸球菌對(duì)絕大多數(shù)抗菌藥物的耐藥率顯著低于屎腸球菌,未發(fā)現(xiàn)對(duì)利奈唑胺耐藥株,檢出3株萬(wàn)古霉素耐藥屎腸球菌。肺炎鏈球菌青霉素耐藥株檢出率為21.2%,較去年有所增長(zhǎng)。產(chǎn)超廣譜β-內(nèi)酰胺酶(ESBLs)的大腸埃希菌和克雷伯菌屬(肺炎克雷伯菌,產(chǎn)酸克雷伯菌)分別為58.5%和27.4%。銅綠假單胞菌對(duì)亞胺培南耐藥率為16.5%,鮑曼不動(dòng)桿菌對(duì)亞胺培南耐藥率為63.3%。多重耐藥鮑曼不動(dòng)桿菌檢出率為69.4%,較去年略有下降。腸桿菌科細(xì)菌中有小部分碳青霉烯類抗生素耐藥株,較去年相比呈較大幅度上升趨勢(shì),仍以肺炎克雷伯菌為主。結(jié)論細(xì)菌耐藥性仍呈增長(zhǎng)趨勢(shì),尤以耐碳青霉烯類抗生素腸桿菌科細(xì)菌為重,多重耐藥和廣泛耐藥株在某些病區(qū)的流行播散對(duì)臨床構(gòu)成嚴(yán)重威脅,應(yīng)進(jìn)行流行病學(xué)調(diào)查并采取有效的感控措施。
[Abstract]:Objective to investigate the susceptibility and drug resistance of clinical isolates to common antimicrobial agents in the second affiliated Hospital of Nanchang University in 2014. Methods Non-repeated clinical isolates were collected from January 1 to December 31, 2014, and drug sensitivity tests were performed by disk diffusion or automatic instrument method. Drug resistance was analyzed by software WHONET 5.5 according to the 2014 edition of the American Association of Clinical Laboratory Standardization (CLSI). Results A total of 4034 non-repeated clinical isolates were collected, of which 1263 were Gram-positive bacteria (31.3%) and 2771 Gram-negative bacteria (68.7%). The detection rates of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococcus aureus were 25.8% and 79.9%, respectively. No linazolamide and vancomycin resistant strain. 90.4 MRSA was sensitive to compound sulfamethazolium 80.3% MRCNS was sensitive to rifampicin. The resistance rate of Enterococcus faecalis to most antimicrobial agents was significantly lower than that of Enterococcus faecium, and three strains of vancomycin resistant Enterococcus faecalis were not found to be resistant to linazolamide. The detection rate of penicillin-resistant strains of Streptococcus pneumoniae was 21. 2%, which was higher than that of last year. The rates of Escherichia coli and Klebsiella (Klebsiella pneumoniae) producing extended-spectrum 尾 -lactamases (ESBLs) were 58.5% and 27.4%, respectively. The resistance rate of Pseudomonas aeruginosa to imipenem was 16.5 and that of Acinetobacter baumannii to imipenem was 63.3. The detection rate of multi-resistant Acinetobacter baumannii was 69. 4%, slightly lower than last year. A small number of carbapenem antibiotic resistant strains were found in Enterobacteriaceae. Compared with last year, Klebsiella pneumoniae is still the main bacteria. Conclusion the drug resistance of bacteria is still on the increase, especially those of Enterobacteriaceae, a carbapenem resistant antibiotic. The prevalence of multidrug resistance and widespread drug resistance in some areas is a serious threat to clinical practice. Epidemiological investigation should be carried out and effective control measures should be taken.
【作者單位】： 南昌大學(xué)第二附屬醫(yī)院;
【分類號(hào)】：R446.5

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