贛南地區(qū)臨床分離菌耐藥性變遷及多重耐藥菌的流行變化

　　摘   要：目的  了解贛南地區(qū)2013年～2016年臨床分離的主要病原菌分布和多重耐藥菌的流行變化。方法  采用梅里埃Vitek 2 compact對分離的菌株進行鑒定藥敏。結果  4年內共分離41288株細菌，革蘭陰性菌所占比例最高（67.00%）。病原菌分布中大腸埃希菌、鮑曼不動桿菌、銅綠假單胞菌、肺炎克雷伯菌、金黃色葡萄球菌位居前五。阿米卡星、哌拉西林/他唑巴坦對腸桿菌科細菌具有較高的的敏感性，鮑曼不動桿菌對多種常用抗菌藥物呈現高水平耐藥;銅綠假單胞菌對大部分抗菌藥物較敏感，未檢出萬古霉素、利奈唑胺耐藥的菌株。4年間耐甲氧西林金黃色葡萄球菌的檢出均在25.00%以上;耐碳青霉烯腸桿菌科細菌的檢出由2.90%上升至4.70%;耐碳青霉烯鮑曼不動桿菌的檢出逐年下降。結論  贛南地區(qū)CRE的檢出不斷上升，臨床應根據藥敏合理選用抗菌藥物，采取有效防控措施減緩多重耐藥菌的產生。
　　關鍵詞：臨床病原菌;耐藥性;多重耐藥菌
　　中圖分類號：R446.5                                  文獻標識碼：A                                DOI：10.3969/j.issn.1006-1959.2018.05.043
　　文章編號：1006-1959（2018）05-0123-02
　　Changes of Drug Resistance of Clinical Isolates and Epidemic Changes of Multidrug-resistant Bacteria in Southern Guizhou
　　ZHANG Li-qin，LIU Ting，LIU Cong，ZOU Shu-hui，XIAO Jiu-chang
　　（Department of Laboratory，Ganzhou People"s Hospital，Ganzhou 341000，Jiangxi，China）
　　Abstract：Objective  To investigate the distribution of major pathogenic bacteria and the epidemic changes of multi-drug resistant bacteria in clinical isolates from 2013 to 2016 in south Jiangxi province.Methods  Meridier Vitek 2 compact was used to identify the drug sensitivity of the isolates. Results   In 4 years，41288 strains of bacteria were isolated，and Gram-negative bacteria accounted for the highest proportion（67.00%）.Escherichia coli，Acinetobacter bauman，Pseudomonas aeruginosa，Klebsiella pneumoniae，and Staphylococcus aureus were the top five in the distribution of pathogenic bacteria.The sensitivity of Amikacin and piperacillin/ tazobactam have higher of Enterobacteriaceae，Bauman acinetobacter to multiple antibiotics showed a high level of resistance; Pseudomonas aeruginosa to most sensitive antibacterial drugs， no detection of vancomycin and linezolid resistant strains.Over the past 4 years，the detection of methicillin-resistant Staphylococcus aureus was over 25.00%，and the detection of carbapenem Enterobacteriaceae increased from 2.90% to 4.70%.The detection of carbapenem resistant Acinetobacter bauman decreased year by year.Conclusion  The detection of CRE is increasing in Gannan area.The rational use of antibiotics should be selected according to drug sensitivity，and effective prevention and control measures should be taken to slow down the production of multi drug resistant bacteria.

相關熱詞搜索：耐藥性 耐藥 變遷 臨床 贛南