2015－2022年某三甲医院临床分离主要病原菌及耐药性监测

林楠; 杨大超; 高留英; 郭艳玲; 兰小琴

doi:10.3784/jbjc.202306190296

2015－2022年某三甲医院临床分离主要病原菌及耐药性监测

Surveillance for main pathogens and drug resistance of clinical isolates in a grade Ⅲ (A) hospital, 2015−2022

摘要

摘要:
目的研究2015—2022年某三甲医院临床分离的主要病原菌及其耐药趋势，为临床治疗提供有效依据。
方法回顾分析医院近8年临床分离病原菌类别及耐药情况，采用VITEK-2 Compact仪器对细菌进行鉴定及药敏试验。参照美国临床和实验室标准化协会（Clinical and Laboratory Standards Institute，CLSI）推荐的方法，采用WHONET 5.6软件对细菌耐药结果进行统计。
结果 2015年1月至2022年12月临床分离菌株共15612株，其中革兰阳性菌占比20.50%，革兰阴性菌占79.50%。排名前10位的病原菌分别为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌、奇异变形杆菌、粪肠球菌、屎肠球菌、嗜麦芽寡养单胞菌和无乳链球菌。耐碳青霉烯类肠杆菌检出率由14.02%上升至33.56%，耐甲氧西林金黄色葡萄球菌检出率由40.68%下降至10.09%。常见病原菌整体耐药率较高，肺炎克雷伯菌及金黄色葡萄球菌耐药率上升明显。
结论该医院近8年临床分离常见病原菌耐药形势严峻，应加强院内感染防控并持续进行耐药性监测，指导临床合理用药。

Abstract:
Objective To understand the main pathogenic bacteria and the drug resistance of clinical isolates in a grade Ⅲ (A) hospital from 2015 to 2022, and provide evidence for clinical treatment.
Methods The types and drug resistance of pathogenic bacteria isolated in the hospital in recent 8 years were retrospectively analyzed. VITEK-2 Compact instrument was used to identify and test the drug susceptibility of bacteria. According to the method recommended by Clinical and Laboratory Standards Institute (CLSI), WHONET 5.6 software was used to calculate the results of bacterial drug resistance.
Results From January 2015 to December 2022, a total of 15 612 pathogenic strains were clinically isolated, in which Gram-positive bacteria accounted for 20.50% and Gram-negative bacteria accounted for 79.50%. The top 10 pathogens were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Proteus mirabilis, Enterococcus faecalis, Enterococcus faecium, Stenotrophomonas maltophilial, and Streptococcus agalactia. The detection rate of carbapenem-resistant enterobacter increased from 14.02% to 33.56%, and the detection rate of methicillin-resistant S. aureus decreased from 40.68% to 10.09%. The overall drug resistance rate to common pathogens was high. The drug resistance rates to K. pneumoniae and S. aureus increased significantly.
Conclusion In recent 8 years, the drug resistance of common pathogens isolated in our hospital was serious. It is necessary to further strengthen the prevention and control of hospital infection and continue to monitor drug resistance for rational drug use in clinical practice.

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