【摘要】 目的 监测深圳某中医医院2020年至2022年分离菌株的构成及对抗菌药物的耐药性，为中医医院院感防控及临床经验用药提供参考依据。方法 选取深圳市某中医院2020至2022年门诊及住院患者标本，采用自动化仪器法、纸片扩散法及E-Test法进行药物敏感试验，以CLSI 2022年文件为标准，利用WHONET 5.6软件对本院三年数据进行分析。结果 2020-2022年三年共分离到非重复菌株6 564株，其中住院患者分离出4 232株（64.5%），门诊患者分离2 332株（35.5%）。住院患者分离前5位细菌分别是大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌、鲍曼不动杆菌；门诊患者分离前5位的细菌分别是无乳链球菌、大肠埃希菌、凝固酶阴性葡萄球菌、粪肠球菌、淋病奈瑟菌。三年来MRSA的检出率为12.3%～21.1%。粪肠球菌的耐药率显著低于屎肠球菌。肠杆菌目中，大肠埃希菌产超广谱内酰胺酶（ESBL）率为40.2%～43.4%，肺炎克雷伯菌产ESBL率为23.7%～38.2%。非发酵菌中，铜绿假单胞菌和鲍曼不动杆菌对大多数抗菌药物的耐药率低于全国水平。CRE检出率为3.2%～3.9%，其中以耐碳青霉烯肺炎克雷伯菌（CRKP）为主。结论 本院三年来耐碳青霉烯铜绿假单胞菌（CRPA）的检出率保持平稳，耐碳青霉烯鲍曼不动杆菌（CRAB）明显下降，MRSA、CRE略有升高，但低于全国水平，应加强院感防控。更多还原

【Abstract】 Objective To monitor the composition and antimicrobial resistance of isolates isolated from a hospital of traditional Chinese Medicine in Shenzhen from 2020 to 2022,so as to provide a reference for hospital infection prevention and control and clinical empirical drug use in hospitals of traditional Chinese medicine. Methods Specimens of outpatient and inpatient patients from a traditional Chinese medicine hospital in Shenzhen from 2020 to 2022 were selected. Antimicrobial susceptibility testing was carried out according to the CHINET unified protocol using the Kirby-Bauer method,automated systems,and the E-test method. Results were interpreted according to the breakpoints recommended by the Clinical and Laboratory Standards Institute in 2020. Three years of data were retrospectively analyzed by WHONET 5.6 software. Results A total of6564 non-repeating strains were isolated from 2020 to 2022,among which 4232(64.5%)were isolated from inpatients and 2332(35.5%)were isolated from outpatients. The top 5 isolates of hospitalized patients were Escherichia coli、 Klebsiella pneumoniae、Pseudomonas aeruginosa、Staphylococcus aureus and Acinetobacter baumannii. The top 5 isolates of outpatients were Streptococcus agalactiae、Escherichia coli、Coagulase negative staphylococci,Enterococcus faecalis、Neisseria gonorrhoeae. The detection rate of methicillin-resistant Staphylococcus aureus(MRSA)in the past three years was 12.3%～21.1%. The resistance rate of Enterococcus faecalis is significantly lower than that of Enterococcus faecalis. Among Enterobacteriaceae,the production rate of extended-spectrum lactamases(ESBL)by Escherichia coli is 40.2%～43.4%,and the production rate of ESBL by Klebsiella pneumoniae is 23.7% ～38.2%. Among non-fermenting bacteria,the resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to most antibiotics are lower than the national level. The detection rate of CRE is 3.2% ～3.9%,with carbapenem-resistant Klebsiella pneumoniae(CRKP)being the main strain. Conclusions The detection rate of carbapenem-resistant Pseudomonas aeruginosa(CRPA)in our hospital has remained stable over the past three years,while that of carbapenem-resistant Acinetobacter baumannii(CRAB)has significantly decreased. The detection rate of MRSA and CRE slightly increased,but lower than the national level. The prevention and control of hospital infection should be strengthened.更多还原