作　　者： (张杰）; (黄湘宁）; (龙姗姗）; (殷琳）; (喻华）;

机构地区： 四川省人民医院·四川省医学科学院检验科,成都610072

出　　处： 《中国循证医学杂志》 2017年第9期1011-1014,共4页

摘　　要： 目的分析四川省细菌耐药监测网成员单位2016年血流感染病原菌分布及耐药情况,为我省临床抗菌药物合理应用提供依据。方法收集71家四川省细菌耐药监测网血培养阳性菌株14 543例,菌株鉴定到种,药敏试验采用MIC法和纸片扩散法(KB法),结果按CLSI 2016年版标准判读,用WHONET 5.6软件进行耐药性分析。结果 14 543株菌中,占比前5位的是大肠埃希菌(34.5%),肺炎克雷伯菌(10.7%)、表皮葡萄球菌(10.2%)、金黄色葡萄球菌(7.2%)和人葡萄球菌(6.0%)。大肠埃希菌对亚胺培南的耐药率是0.9%。肺炎克雷伯菌对亚胺培南的耐药率是2.4%。未发现对万古霉素、替考拉宁耐药的表皮葡萄球菌、金黄色葡萄球菌和人葡萄球菌。MRSA检出率为25.8%。结论 2016年四川省细菌血流感染以革兰阴性菌为主,也应重视葡萄球菌感染。 Objective To analyze distribution and drug resistance of pathogens in bloodstream infection in Sichuan Antibiotic Resistance Monitoring Network in 2016, and to provide the basis for clinical rational use of antimicrobial drugs in Sichuan province. Methods A total of 14 543 strains of bacteria in bloodstream infection were collected from Sichuan Antibiotic Resistance Monitoring Network in 2016. Bacteria strains were identified to species, drug susceptibility test was performed by using the MIC and disc diffusion method （KB method）. The results were interpreted according to the clinical laboratory standards institute CLSI 2016. Drug resistance was analyzed by using WHONET 5.6 software. Results Among the 14 543 strains of bacteria, Escherichia coli （34.5%）, Klebsiella pneumoniae （10.7%）, Staphylococcus epidermidis （10.2%）, Staphylococcus aureus （7.2%）, Staphylococcus hominis （6.0%） ranked the first five. Resistance rate to imipenem was 0.9% for Escherichia coli, resistance rate to imipenem was 2.4% for Klebsiella pneumoniae. No vancomycin-resistance and linezolid-resistance Staphylococcus epidermidis, Staphylococcus aureus and Staphylococcus hominis were found. MRSA detection rate was 25.8%. Conclusion Gram negative bacteria are the main pathogens in the blood cultures in Sichuan province, while attention should pay to the Staphylococcus.

关 键 词： 血流感染 四川省 耐药