河北医科大学学报

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2016—2017年河北省三级医院血培养分离细菌分布及耐药性分析

  

  1. 1.河北医科大学第二医院河北省临床检验中心,河北 石家庄 050000;2.河北医科大学第二医院检验科,河北 石家庄 050000;3.河北医科大学第四医院科研中心,河北 石家庄 050011
  • 出版日期:2019-11-25 发布日期:2019-11-21
  • 作者简介:李志荣(1985-),男,河北涉县人,河北医科大学第二医院中级检验师,医学硕士,从事临床检验学研究。
  • 基金资助:
    河北省科技支撑计划项目(152777238)

Analysis of pathogen distribution and drug resistance in blood samples of different ages from Tertiary hospitals in Hebei province during 2016-2017#br#

  1. 1.Hebei Provincial Center for Clinical Laboratory, the Second Hospital of Hebei Medical University,
    Shijiazhuang 050000, China; 2.Department of Clinical Laboratory,the Second Hospital of Hebei
    Medical University, Shijiazhuang 050000, China; 3.Department of Research Center,
    the Forth Hospital of Hebei Medical University, Shijiazhuang 050011, China
  • Online:2019-11-25 Published:2019-11-21

摘要: [摘要]
〖HTH〗目的〖HTSS〗〖KG*2〗了解河北省三级医院血培养分离菌的分布及其对抗菌药物的耐药情况。
〖HTH〗方法〖HTSS〗〖KG*2〗收集2016—2017年河北省细菌耐药监测网三级医院血培养分离细菌的药敏数据,依据美国临床和实验室标准协会2016年标准判定结果。
〖HTH〗结果〖HTSS〗〖KG*2〗血培养共收集细菌17 815株,其中革兰阴性菌占54.1%,革兰阳性菌占45.9%。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46.3%和80.0%。葡萄球菌属中没有发现对替考拉宁、万古霉素、利奈唑胺耐药的菌株。屎肠球菌对万古霉素、替考拉宁和利奈唑胺的耐药率分别为1.4%、1.9%和0.4%,而粪肠球菌则分别为0.0%、0.6%和1.1%。青霉素耐药肺炎链球菌检出率为5.9%。大肠埃希菌和肺炎克雷伯菌的超广谱β-内酰胺酶阳性分离率分别为65.4%和43.8%,大肠埃希菌和肺炎克雷伯菌对亚胺培南的耐药率分别为1.8%和15.7%,对美罗培南的耐药率分别为1.6%和15.7%。铜绿假单胞菌对所测抗菌药物的耐药率均低于30.0%。鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率为19.3%,对亚胺培南和美罗培南的耐药率高达60.9%和53.8%。
〖HTH〗结论〖HTSS〗〖KG*2〗血培养分离菌以革兰阴性菌为主,对常用抗菌药物有不同程度的耐药。加强细菌耐药动态监测,对合理应用抗菌药物具有重要意义。

关键词: 血培养, 细菌耐药监测, 抗菌药物

Abstract: [Abstract]Objective〖HTSS〗To investigate the pathogen distribution and antimicrobial resistance of the isolates from blood samples from tertiary hospitals in antimicrobial resistance surveillance system of Hebei province.
〖HTH〗〖WTHZ〗Methods〖HTSS〗Clinical isolates from blood specimens were collected during 2016-2017. The data of antimicrobiol resistance were analyzed according to CLSI 2016.
〖HTH〗〖WTHZ〗Results〖HTSS〗A total of 17 815 bacteria including 45.9% Gram-negative strains and 54.1% Gram-positive strains was isolated. Methicillin-resistant staphylococcus aureus(MRSA) and methicillin-resistant coagulase-negative staphylococcus(MRCNS) accounted for 46.3% and 80.0%, respectively. None of staphylococcal strains were found resistant to vancomycin, teicoplanin or linezolid. The resistance rates of E. faecium to vancomycin and teicoplanin were 1.4% and 1.9%, respectively. The resistance rates of E. faecali to vancomycin and teicoplanin were 0.0% and 0.6%, respectively. The resistance rate of E. faecium and E. faecali to linezolid was 1.1% and 0.4%.The prevalence of penicillin-resistant S. pneumoniae isolated was 5.4%. The prevalence of ESBL-producing of E. coli and K. pneumoniae were 65.4% and 43.8%, respectively. Resistance rates of E. coli to imipenem and meropenem were 1.8% and 1.6%, respectively. Resistance rates of K. pneumoniae to imipenem and meropenem were 15.7% and 15.7%, respectively. The resistance rates of P. aeruginosa to all the drugs tested in this study were lower than 30.0%. Resistance rate of A. baumannii strains to cefoperazone-sulbactam was 19.3%. However, the Resistance rates of A. baumannii strains to imipenem and meropenem were much higher up to 60.9%and 53.8%,respectively.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Gram-negative bacteria are still the main pathogen of bloodstream infections. Isolates from blood specimens are showing various levels of resistance to common antimicrobial agents. Dynamic monitoring of bacterial resistance is of great significance to the rational use of antibiotic.

Key words: blood specimen, bacterial resistance surveillance, antimicrobial agent