【摘要】 目的了解2018年中南大学湘雅医院临床分离细菌的分布和药物敏感性,为临床合理使用抗菌药物提供依据。方法采用标准纸片扩散法或自动化仪器检测法,测定细菌对临床常用抗菌药物的敏感性,根据CLSI 2018年标准判断结果,用WHONET 5.6软件进行数据分析。结果 2018年分离非重复菌株7362株,其中革兰阳性菌2 543株,占34.5%;革兰阴性菌4819株,占65.5%。MRSA和MRCNS分别占各自菌种的30.3%和75.5%。检出3株对利奈唑胺耐药的粪肠球菌。肺炎链球菌非脑膜炎分离株中儿童100%为青霉素敏感株(PSSP),成人为95.8%。大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌中产ESBL菌株分别占54.0%、34.8%和34.9%。耐碳青霉烯类大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌分别占各自菌种的2.6%、20.0%、23.5%、87.5%。鲍曼不动杆菌对替加环素的耐药率较低(4.4%)。流感嗜血杆菌β内酰胺酶阳性率为41.6%。结论该院细菌耐药形势比较严峻,应重视细菌耐药监测工作并采取有效的医院感染控制措施。更多还原

【Abstract】 Objective To investigate the distribution and antimicrobial resistance of the clinical strains isolated from Xiangya Hospital of Central South University in 2018 and provide basis for clinical rational use of antibiotics. Methods All the clinical isolates in 2018 were collected. Antimicrobial susceptibility was tested by Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2018 breakpoints and analyzed by software WHONET 5.6. Results A total of 7 362 nonduplicate strains were isolated in 2018, including 2 543(34.5%) strains of gram-positive bacteria and 4 819(65.5%) strains of gram-negative bacteria. The prevalence of methicillin-resistant strains was 30.3% in S. aureus(MRSA) and 75.5% in coagulase negative Staphylococcus(MRCNS). There are three strains of linezolid-resistant Enterococcus faecalis. As for the non-meningitis S. pneumoniae, the prevalence of PSSP was 100% in the isolates from children and 95.8% in the isolates from adults. The prevalence of ESBLs-producing strains in E. coli, K. pneumoniae and P. mirabilis was 54.0%, 34.8% and 34.9%, respectively. The prevalence of carbapenem-resistant E. coli, carbapenemresistant K. pneumoniae, carbapenem-resistant P. aeruginosa and carbapenem-resistant A. baumannii was 2.6%, 20.0%, 23.5%, and 87.5%, respectively. A. baumannii isolates showed lower resistance rate to tigecycline(4.4%). Beta-lactamase was produced in 41.6% of H. influenzae isolates. Conclusions Bacterial resistance is still serious in this hospital. It is necessary to pay more attention to surveillance of antimicrobial resistance and take effective measures to control hospital infections.更多还原