摘要： 目的 探讨2019年中国医科大学附属第一医院临床分离菌株对常用抗菌药物的耐药率，为临床经验性抗感染治疗提供依据。方法 收集2019年1月至12月我院检验科分离的非重复细菌，按统一方案进行菌株鉴定及药敏检测，应用Whonet 5.6软件对数据进行分析。结果 2019年共收集5 061株非重复菌株，其中，革兰阳性菌占31.4%，革兰阴性菌占68.6%。葡萄球菌属中耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）的检出率分别为32.3%和82.3%，粪肠球菌对多数抗菌药物的耐药率均低于屎肠球菌。肠杆菌科细菌对碳青霉烯类的耐药率分别为：肺炎克雷伯菌18.9%、阴沟肠杆菌7.0%、大肠埃希菌1.3%、奇异变形杆菌1.0%。鲍曼不动杆菌对美罗培南和亚胺培南的耐药率分别为81.2%和82.0%。结论 我院临床分离的常见细菌对不同抗菌药物呈不同耐药率，应充分了解细菌耐药监测结果，合理使用抗菌药物并加强医院感染管理。

2019年中国医科大学附属第一医院细菌耐药性监测结果分析

陈静静, 李富顺, 田素飞, 孙国全, 褚云卓

中国医科大学附属第一医院检验科, 沈阳 110001

收稿日期:2020-04-20出版日期:2021-03-30发布日期:2021-03-20
通讯作者:褚云卓E-mail:cyz6630@163.com
作者简介:陈静静(1987-),女,主管检验技师,博士.



关键词: 细菌耐药监测, 药物敏感率, 耐甲氧西林葡萄球菌, 耐万古霉素肠球菌, 碳青霉烯耐药肠杆科细菌
Abstract: Objective To explore the resistance and sensitivity rate of clinical isolates to the commonly used antimicrobials in the First Hospital of China Medical University in 2019. Methods Non-duplicate bacteria collected from the First Hospital of China Medical University from January 1 to December 31,2019,were subjected to strain identification and drug susceptibility testing according to the defined protocol. The data were processed using Whonet 5.6. Results A total of 5 061 non-repeating isolates were collected in 2019,among which gram-positive bacteria accounted for 31.4% and gram-negative bacteria for 68.6%. The detection rates of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococci were 32.3% and 82.3%,respectively,with no Staphylococcus bacteria resistant to vancomycin,linezolid,and tigecycline. The resistance rate of E. faecium to most antimicrobials was lower than that of E. faecium. Approximately 1.7% of E. faecium isolates were resistant to vancomycin,and 3.3% of E. faecium was resistant to linezolid. The detection rates of extended-spectrum β-lactamase in E. coli,K. pneumoniae,and P. mirabilis were 53.8%,44.2%,and 44.4%,respectively. The detection rates of carbapenem-resistant Enterobacteriaceae were as follows:K. pneumoniae 18.9%,E. cloacae 7.0%,E. coli 1.3%,and P. mirabilis 1.0%. The resistance rates of A. baumannii to meropenem and imipenem were 81.2% and 82.0%,while that of P. aeruginosa were 23.4% and 30.0%,respectively. Conclusion Common bacteria isolated in our hospital showed different resistance rates to different antibacterial drugs. Therefore,we should fully understand bacterial resistance profiles for the rational use of antimicrobials and nosocomial infection management.
Key words: bacterial resistance monitoring, drug sensitivity rate, methicillin-resistant Staphylococcus, vancomycin-resistant Enterococci, carbapenem-resistant Enterobacteriaceae
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