2016-2017年河北省二级医院血液标本细菌分布及耐药性分析  

Analysis of pathogen spectrum and drug resistance in blood samples from the secondary hospitals in Hebei province in 2016-2017

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作  者:李志荣[1,2] 赵建宏 李继红[1] 范士英 孙倩[1] 时东彦[1] LI Zhi-rong;ZHAO Jian-hong;LI Ji-hong;FAN Shi-ying;SUN Qian;SHI Dong-yan(Department of Clinical Laboratory,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Hebei Provincial Center for Clinical Laboratory,Shijiazhuang 050000,China)

机构地区:[1]河北医科大学第二医院检验科,河北石家庄050000 [2]河北省临床检验中心,河北石家庄050000

出  处:《河北医科大学学报》2019年第3期342-346,共5页Journal of Hebei Medical University

基  金:河北省科技计划项目(152777238).

摘  要:目的了解河北省二级医院血标本分离菌的分布及其对抗菌药物的耐药情况。方法收集河北省细菌耐药监测网二级医院2016-2017年血标本分离细菌的药物敏感数据,依据CLSI 2016年标准判定结果,应用WHONET 5.6软件进行数据分析。结果血培养共收集细菌2 909株,其中革兰阴性菌1 684株(57.9%),革兰阳性菌1 225株(42.1%)。耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌检出率分别为50.0%和72.1%。葡萄球菌属中未发现对万古霉素、替考拉宁、利奈唑胺耐药的菌株。粪肠球菌和屎肠球菌对万古霉素耐药率分别为2.7%和1.8%,两者对替考拉宁和利奈唑胺的耐药率均为0。大肠埃希菌超广谱β-内酰胺酶(extended spectrum beta-lactamases,ESBL)的分离率为50.3%,肺炎克雷伯菌ESBL的分离率为26.2%。大肠埃希菌对亚胺培南和美罗培南的耐药率分别为6.1%和1.0%;肺炎克雷伯菌对亚胺培南和美罗培南的耐药率为5.7%和6.2%;铜绿假单胞菌对亚胺培南和美罗培南的耐药率均为34.0%,对其他检测抗生素的耐药率均低于30.0%;鲍曼不动杆菌对亚胺培南和美罗培南的耐药率为34.0%和42.5%。结论血标本分离细菌菌种不断变化,评估不同细菌的致病性对于临床诊治非常重要,不同菌种对常用抗菌药物有不同程度的耐药,应根据药物敏感结果合理选择抗菌药物。Objective To investigate the pathogen distribution of blood samples isolated from second-grade hospitals in Hebei and their resistance to antibiotics.Methods Drug resistance data of isolated bacteria of blood sample from second-grade hospitals during 2016-2017 were analysed by Whonet 5.6 software according to CLSI 2016.Results A total of 2 909 strains of bacteria were collected by blood culture,of which 1 684 strains were G-strains(57.9%)and 1 225 strains were G+strains(42.1%).Methicillin-resistant S.aureus(MRSA)and coagulase-negative Staphylococcus(MRCNS)accounted for 50.0%and 72.1%,respectively.No staphylococcal strains were found resistant to vancomycin,teicoplanin or linezolid.The resistance rates of E.faecalis and E.faecium to vancomycin were 2.7%and 1.8%,respectively.Both of these two kinds of strain have no resistance to teicoplanin or linezolid.The prevalence of ESBL-producing of E.coli and K.pneumonia were 50.3%and 26.2%,respectively.Resistance rates of E.coli to imipenem and meropenem were 6.1%and 1.0%,respectively.Resistance rates of K.pneumoniae to imipenem and meropenem were 5.7%and 6.2%,respectively.The resistance rates of P.aeruginosa to imipenem and meropenem were both 34.0%.The resistance rates of other antibiotics for P.aeruginosa were lower than 30.0%.The Resistance rates of A.baumannii strains to imipenem and meropenem were 34.0%and 42.5%.Conclusion It is important to evaluate the pathogenicity of different bacteria for clinical diagnosis and treatment.The pathogens isolated from blood specimens are diverse showing various levels of resistance to common antimicrobial agents.Antibiotics should be prescribed reasonably according to local susceptibility testing data.

关 键 词:抗药性 细菌 抗菌药物 血标本 

分 类 号:R378[医药卫生—病原生物学;医药卫生—基础医学]

 

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