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1. 内江市第二人民医院检验科
2. 内江市第一人民医院检验科
3. 西南医科大学病原生物学教研室
纸质出版日期:2020,
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[1]付魏萍,袁翊,王小龙,张淑霞,钟方财,张禄滑,袁平宗.2018年内江市两家三甲综合医院细菌耐药性监测分析[J].西南医科大学学报,2020,43(05):450-455.
FU Weiping, YUAN Yi, WANG Xiaolong, et al. Surveillance of antimicrobial resistance in two grade A tertiary general hospitals in Neijiang,Sichuan Province,China,2018[J]. Journal of Southwest Medical University, 2020,43(5):450-455.
[1]付魏萍,袁翊,王小龙,张淑霞,钟方财,张禄滑,袁平宗.2018年内江市两家三甲综合医院细菌耐药性监测分析[J].西南医科大学学报,2020,43(05):450-455. DOI:
FU Weiping, YUAN Yi, WANG Xiaolong, et al. Surveillance of antimicrobial resistance in two grade A tertiary general hospitals in Neijiang,Sichuan Province,China,2018[J]. Journal of Southwest Medical University, 2020,43(5):450-455. DOI:
目的:了解内江两所三甲综合医院2018年临床分离菌对抗菌药物的耐药性。方法:采用纸片法、E-test法或自动化仪器法进行临床分离株的药敏试验。参照CLSI 2018版折点进行结果判读
使用WHONET5.6软件进行统计分析。结果:2018年共收集非重复临床分离株5 285株
其中革兰阴性菌3 662株(69.3%)
主要由大肠埃希菌
克雷伯菌属构成;革兰阳性菌1 623株(30.7%)
主要由金黄色葡萄球菌
凝固酶阴性葡萄球菌
肠球菌属构成。甲氧西林耐药的金黄色葡萄球菌和凝固酶阴性葡萄球菌株的检出率分别为33.7%和81.9%。甲氧西林耐药株对除复方新诺明外的大多数测试药耐药率均高于甲氧西林敏感株
未检出万古霉素和利奈唑胺耐药菌株。肠球菌属细菌中以粪肠球菌和屎肠球菌为主
粪肠球菌除四环素外
其余10种抗菌药的耐药率均显著低于屎肠球菌。粪肠球菌检出少量万古霉素耐药株。肺炎链球菌检出少量对青霉素耐药株。大肠埃希菌和肺炎克雷伯菌产ESBLs的阳性率分别为62.7%、27.5%。肠杆菌科细菌对测试碳青霉烯类的耐药率均较低(<10%)。铜绿假单胞菌对亚胺培南耐药率为12.6%
不动杆菌属对对亚胺培南耐药率为45.4%
嗜麦芽窄食单胞菌对复方新诺明和左氧氟沙星的敏感率均在80%以上。流感嗜血杆菌和卡他莫拉菌β内酰胺酶阳性率分别为66.2%和99.5%。结论:细菌耐药性日趋严重
应加强抗菌药物临床应用管理和医院感染防控措施
重视细菌耐药性监测工作。
Objective: To investigate the antimicrobial resistance of the clinical strains isolated from two grade A tertiary general hospitals in Neijiang
Sichuan province
China
2018. Methods: The Kirby-Bauer disc diffusion method
E-test stripes
or an automated system was used to carry out the antimicrobial susceptibility test. The data were interpreted according to the breakpoints from the CLSI guidelines(2018). WHONET 5.6 software was used for statistical analysis. Results: A total of 5 285 non-repetitive clinical isolates were collected in 2018
of which 3 662(69.3%) were Gram-negative bacteria
mainly comprising Escherichia coli and Klebsiella spp.
and 1 623(30.7%)were Gram-positive bacteria
mainly comprising Staphylococcus aureus
coagulase-negative Staphylococcus
and Enterococcus spp. Among them
33.7% of the S. aureus isolates and 81.9% of the coagulase-negative Staphylococcus isolates showed resistance to methicillin. The methicillin-resistant isolates had higher resistance rates to most of the antibiotics tested(except trimethoprim-sulfamethoxazole) than the methicillin-susceptible isolates. No isolates were found resistant to linezolid or vancomycin. Enterococcus faecalis and E. faecium were the major isolates in Enterococcus
and the E. faecalis isolates had much lower resistance rates to ten antibiotics(other than tetracyclines)than the E. faecium isolates. A few E. faecalis isolates showed resistance to vancomycin. A few Streptococcus pneumoniae isolates showed resistance to penicillin. In addition
62.7% of the E. coli isolates and 27.5% of the K. pneumoniae isolates produced extended-spectrum β-lactamases. The Enterobacteriaceae isolates had relatively low resistance rates( < 10%) to carbapenems. The Pseudomonas aeruginosa isolates had a resistance rate of 12.6% to imipenem
and the Acinetobacter spp. isolates had a resistance rate of 45.4% to it. The Stenotrophomonas maltophilia isolates showed a high susceptibility rate( > 80%) to trimethoprim-sulfamethoxazole and levofloxacin. And 66.2% of the Haemophilus influenzae isolates and 99.5% of the Moraxella catarrhalis isolates produced β-lactamase. Conclusion: Bacteria have developed increasingly high antimicrobial resistance. It is necessary to strengthen the antimicrobial agent management in clinical application and the nosocomial infection control
and pay more attention to the surveillance of antimicrobial resistance.
耐药性监测抗菌药物碳青霉烯类耐药
Antimicrobial resistance surveillanceAntimicrobial agentCarbapenem resistance
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