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山东省东阿县2014-2015年病原菌分布特征及耐药性分析

     

摘要

OBJECTIVE:To analyze the distribution characteristics and drug resistance of pathogens in Shandong Dong’e and to provide reference for local physicians to choose antimicrobial agents. METHODS:Detected pathogens in Dong’e coun-ty of Shandong province during Jan. 2014-Dec. 2015 were analyzed statistically in respects of type,distribution and drug re-sistance. RESULTS:A total of 25 562 specimens were collected from Dong’e county of Shandong province during 2014-2015,and there were 6 302 positive samples with positive rate of 24.65%. The samples with high positive rate included respiratory samples(positive rate of 34.52%)and secretion,pus(positive rate of 33.79%). A total of 6 350 pathogens were detected,among which there were 3 707 strains of Gram-positive bacterias (58.38%),mainly including Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia;2 042 strains of Gram-negative bacterias (32.16%),mainly including Staphylococcus aureus and Streptococcus pneumonia;601 strains of fungus. E. coli,S. aureus,P. aeruginosa,K. pneumonia, Acinetobacter baumannii and Proteus mirabilis mainly distributed in ICU,and S. pneumonia and Hemophilus influenza mainly distributed in pediatric department. Sensitive rates of E. coli and K. pneumonia to piperacillin sodium and tazobactam sodium, imipenem,amikacin and tigecycline were higher than 90%;the strain resistant to or intermediate to tigecycline was not found. Sensitive rate of P. aeruginosa to aminoside antimicrobial agents was higher than 90%. Resistant rates of A. baumannii to vari-ous antimicrobial agents were higher than 70%,and resistant rate of it to minocycline was 96.67%. S. aureus was sensitive to vancomycin,quinupristin/dalfopristin and tigecycline,and S. pneumonia was sensitive to rifarnpin,linezolid and vancomycin, with sensitive rate of 100%. A total of 264 strains of MRSA were detected,and detection rate was 39.28%;a total of 200 strains of penicillin-resistant S. pneumonia were detected,and detection rate was 35.13%. CONCLUSIONS:The samples from Dong’e county of Shandong province during 2014-2015 were mainly respiratory samples,detected pathogens were mainly Gram-negative bacterias and resistant rate of them were lower than related domestic reports. The distribution characteristics and drug resistance of pathogens should be considered before using antimicrobial agents to improve the rationality and perti-nence of drug use.%目的:分析山东省东阿县病原菌分布特征及耐药性,为当地医师合理选择抗菌药物提供依据。方法:对山东省东阿县2014年1月-2015年12月检出病原菌的种类、分布及其耐药性进行统计、分析。结果:2014-2015年山东省东阿县共送检标本25562份,阳性标本6302份,阳性率为24.65%;阳性率较高的标本包括呼吸道标本(阳性率34.52%)和分泌物及脓液标本(阳性率33.79%)。共检出病原菌6350株,其中革兰氏阴性菌3707株(58.38%),以大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌为主;革兰氏阳性菌2042株(32.16%),以金黄色葡萄球菌和肺炎链球菌为主;真菌601株(9.46%)。大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌和奇异变形菌主要分布在重症监护病房,肺炎链球菌和流感嗜血菌主要分布在儿科。大肠埃希菌和肺炎克雷伯菌对哌拉西林钠他唑巴坦钠、亚胺培南、阿米卡星和替加环素的敏感率>90%,未检出对替加环素耐药或中介的菌株;铜绿假单胞菌对氨基糖苷类抗菌药物的敏感率>90%;鲍曼不动杆菌对多种抗菌药物的耐药率>70%,对米诺环素的敏感率为96.67%;金黄色葡萄球菌对万古霉素、奎奴普丁/达福普汀和替加环素等敏感,肺炎链球菌对利福平、利奈唑胺和万古霉素敏感,敏感率均为100%;共检出耐甲氧西林金黄色葡萄球菌264株,检出率为39.28%;耐青霉素肺炎链球菌200株,检出率为35.13%。结论:2014-2015年东阿县送检标本以呼吸道标本为主,检出病原菌以革兰氏阴性菌为主,其耐药率总体低于国内相关报道。临床应根据当地病原菌分布特征及耐药性,慎重选择抗菌药物品种,提高用药合理性和针对性。

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