本文選題：細(xì)菌 + 耐藥監(jiān)測��； 參考：《中國感染與化療雜志》2016年01期

【摘要】：目的了解2014年湖北省秭歸縣人民醫(yī)院臨床分離細(xì)菌對抗菌藥物的耐藥性。方法采用紙片擴(kuò)散法(K-B法)對細(xì)菌作藥物敏感性試驗(yàn),以2014年版CLSI標(biāo)準(zhǔn)判斷結(jié)果,采用WHONET 5.6軟件統(tǒng)計(jì)分析。結(jié)果總計(jì)1 338株細(xì)菌,革蘭陽性菌和革蘭陰性菌分別占27.2%和72.8%。金黃色葡萄球菌和凝固酶陰性葡萄球菌耐甲氧西林菌株檢出率分別為30.4%和66.7%,肺炎鏈球菌青霉素敏感、中介和耐藥菌株各占64.9%、24.3%和10.8%。葡萄球菌和肺炎鏈球菌中未發(fā)現(xiàn)萬古霉素、替考拉寧和利奈唑胺耐藥株;屎腸球菌出現(xiàn)1株萬古霉素耐藥株。腸桿菌科細(xì)菌對碳青霉烯類抗生素仍高度敏感,但耐藥菌株亦已出現(xiàn)。大腸埃希菌和克雷伯菌屬產(chǎn)超廣譜β內(nèi)酰胺酶的檢出率分別為58.3%和31.3%。大腸埃希菌對亞胺培南和美羅培南的耐藥率為0和0.4%;肺炎克雷伯菌對亞胺培南和美羅培南的耐藥率均為1.7%;鮑曼不動桿菌對亞胺培南和美羅培南的耐藥率為19.3%和32.1%;銅綠假單胞菌對亞胺培南和美羅培南耐藥率為0.9%和1.8%。廣泛耐藥(XDR)菌株5株,為鮑曼不動桿菌、弗氏枸櫞酸桿菌、大腸埃希菌、肺炎克雷伯菌、銅綠假單胞菌各1株。結(jié)論革蘭陽性菌(除屎腸球菌1株耐萬古霉素外)未發(fā)現(xiàn)萬古霉素、替考拉寧和利奈唑胺耐藥株;革蘭陰性桿菌對碳青霉烯類抗生素高度敏感,但耐藥菌株亦已出現(xiàn)。隨著醫(yī)療設(shè)施不斷完善和提高,擬將2級醫(yī)院納入全國細(xì)菌耐藥監(jiān)測網(wǎng),夯實(shí)網(wǎng)底建設(shè),防止細(xì)菌耐藥性加劇。
[Abstract]:Objective to investigate the antimicrobial resistance of clinical bacteria isolated from Zigui County Hospital of Hubei Province in 2014. Methods the drug sensitivity of bacteria was tested by disk diffusion method (K-B method). The results of CLSI criteria of 2014 edition were analyzed by WHONET 5.6 software. Results A total of 1 338 strains of bacteria, gram-positive bacteria and gram-negative bacteria accounted for 27.2% and 72.8%, respectively. The positive rates of methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococcus were 30.4% and 66.7%, respectively. Streptococcus pneumoniae was sensitive to penicillin, and the intermediate and resistant strains accounted for 64.9% and 10.8%, respectively. Vancomycin, teicoplanin and linazolamide resistant strains were not found in Staphylococcus and Streptococcus pneumoniae, and one vancomycin resistant strain was found in Enterococcus faecium. Enterobacteriaceae bacteria are still highly sensitive to carbapenem antibiotics, but drug-resistant strains have also appeared. The detection rates of extended-spectrum 尾 -lactamases produced by Escherichia coli and Klebsiella were 58.3% and 31.3%, respectively. The resistance rates of Escherichia coli to imipenem and meropenem were 0 and 0.4, those of Klebsiella pneumoniae to imipenem and meropenem were 1.7, those of Acinetobacter baumannii to imipenem and meropenem were 19.3% and 32.1%, respectively. The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 0.9% and 1.8% respectively. Five XDRs were found to be Acinetobacter baumannii, Citrobacter flexneri, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Conclusion No vancomycin, teicoplanin and linazolamide resistant strains were found in Gram-positive bacteria (except one of Enterococcus faecium), and Gram-negative bacilli were highly sensitive to carbapenem antibiotics, but resistant strains were also found. With the continuous improvement and improvement of medical facilities, it is proposed that level 2 hospitals be incorporated into the national bacterial drug resistance monitoring network to consolidate the construction of the bottom of the network to prevent the aggravation of bacterial drug resistance.
【作者單位】： 湖北省秭歸縣人民醫(yī)院檢驗(yàn)科;湖北省秭歸縣梅家河鄉(xiāng)衛(wèi)生院;湖北省秭歸縣楊林橋鎮(zhèn)衛(wèi)生院;湖北省秭歸縣兩河鎮(zhèn)衛(wèi)生院;
【分類號】：R446.5
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本文編號：2041066