世界中医药

作者	单位
郭玉红1，2，3，宫晶书1，刘东国1，刘清泉1，2，3	1 首都医科大学附属北京中医医院，北京，100010； 2 北京中医医院顺义医院，北京，101300； 3 中医感染性疾病基础研究北京市重点实验室，北京，100010

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中文摘要:

目的：监测北京3家三甲中医医院近3年临床分离细菌的耐药状况，指导抗菌药物临床应用，为管理部门制定适合医院的院感措施提供依据。方法：收集2014年1月1日至2016年12月31日北京中医医院、北京中医医院顺义医院以及北京中医医院平谷医院院内感染病原菌，常规方法分离、培养，并将菌株鉴定到种，同时进行药敏试验检测细菌的耐药性，判读标准参照CLSI-2010文件，以WHONET 5.4软件进行数据分析。结果：3家医院按监测方案共分离出细菌21 114株，其中革兰阴性菌株13 971株，占66.2%，包括大肠埃希菌为2 787株，占19.9%；奈瑟氏菌菌株检出率次之，为2 350株，占16.8%；革兰阳性菌7 143株，占33.8%，其中甲型溶血性链球菌3 013株，占42.2%；金黄色葡萄球菌1 542株，占21.6%。结论：基于院内细菌耐药监测基础数据平台，较为全面的掌握了3家监测医院的细菌耐药现状；临床分离细菌耐药现象较为普遍，但近3年细菌耐药率增长趋势较为稳定；大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌等仍需重点监测，同时要加强院内感染控制措施，遏制耐药菌株的流行。

English Summary:

To guide the clinical application of antimicrobial drugs and the administration basis for appropriate measures of nosocomial infection by monitoring the antimicrobial resistance of clinical bacterial isolates in 3 first class hospitals of traditional Chinese medicine in Beijing for three years. Methods:Pathogenic bacteria of nosocomial infection were collected from January 1 st， 2014 to December 31 st， 2016 in Beijing Hospital of Traditional Chinese Medicine， Shunyi Branch of Beijing Hospital of Traditional Chinese Medicine and Pinggu Branch of Beijing Hospital of Traditional Chinese Medicine. Regular methods were used to isolate and cultivate the pathogenic bacteria of nosocomial infection， and the types of strains were identified while antimicrobial resistance of bacteria was measured by antibiotic susceptibility test. CLSI-2010 document was the standard reference and the WHONET 5.4 software was used for data analysis. Results:A total of 21，114 strains were isolated by the 3 hospitals according to the surveillance project. A total of 13，971 strains， 66.2% of the amount， were of Gram-negative， including 2，787 strains of Escherichia coli accounting for 19.9% and then 2，350 strains of Neisseria accounting for 16.8%. And 7，143 strains， 33.8% of the amount， were of Gram-positive， including 3，013 strains of α-hemolytic streptococcus accounting for 42.2% and 1，542 strains of Staphylococcus aureus accounting for 21.6%. Conclusion:Based on the basic data platform for the monitoring of antimicrobial resistance of nosocomial bacteria， the status of bacteria resistance in the 3 monitoring hospitals are now generally detected. It’s common that the clinical bacterial isolates have resistance to drugs， and the resistance rate is increasing but stable in the past three years. Escherichia coli， Staphylococcus aureus， Pseudomonas aeruginosa， etc. should remain focused on monitoring， and the control measures of nosocomial infection should be strengthened to curb the spread of drug-resistant strains.

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