医院常见致病菌菌群分布及其耐药性分析

Distribution and Drug Resistance of Commonly Encountered Bacteria in Hospital

目的 了解医院临床分离致病菌菌群的分布及耐药性,为细菌性感染的诊断与治疗提供依据。方法 按《全国临床检验操作规程》培养分离菌种, VITEK 60 鉴定仪进行细菌鉴定,纸片扩散法进行药物敏感试验。结果 分离出的1 910株细菌中,革兰阳性球菌占 46 8%,革兰阴性杆菌占 53 2%;分离率由高到低分别为:耐苯唑西林凝固酶阴性葡萄球菌 14 9%,铜绿假单胞菌 14 7%,耐苯唑西林金黄色葡萄球菌 11 8%,不产超广谱β 内酰胺酶大肠埃希菌9 9%,产超广谱β 内酰胺酶大肠埃希菌 8 3%,粪肠球菌 6 8%,苯唑西林敏感金黄色葡萄球菌5 9%,苯唑西林敏感凝固酶阴性葡萄球菌5 2%,不动杆菌属5 1%,不产超广谱β 内酰胺酶肺炎克雷伯菌4 7%,产超广谱β 内酰胺酶肺炎克雷伯菌4 6%,阴沟肠杆菌3 7%等。结论 了解常见致病菌菌群分布及耐药性特点,有助于临床根据不同情况合理、安全选用抗生素,对控制医院感染至关重要。

OBJECTIVE To investigate the distribution and drug resistance of the pathogenic floras isolated from the clinical specimen,and provide reference for the clinical diagnosis and treatment of bacterial infection. METHODS Flora cultivation and isolation was operated with the methods descripted by the National Clinical Laboratory Operational Regulations. Flora was identified with the VITEK 60 automatic identifier, and bacteriostatic test was operated with Kirby Bauer method. RESULTS The proportion of Gram positive cocci and Gram negative bacilli was 46 8% and 53 2%, respectively in 1 910 isolated strains. The proportion of these strains from high to low were oxacillin resistant, coagulase negative Staphylococcus(MRSCN) 14 9%, Pseudomonas aeruginosa 14 7%, Enterococcus faecalis 12 3%, oxacillin resistant S. aureus(MRSA) 11 8%,Escherichia coli (produced no ESBLs 9 9%,or produced ESBLs 8 3%), E.faecalis 6 8%,oxacillin sensitive S. aureus (MSSA) 5 9%,oxacillin sensitive coagulase negative(MSSCON)5 2%,Acinetobacter 5 1%,Klebsiella pneumoniae (produced no ESBLs 4 7%, or produced ESBLs 4 6%), and Enterobacter cloacae 3 7%, respectively. No vancomycin resistant strain was isolated. Gram negative bacilli were more sensitive to imipenem, meropenem, piperacillin/clavulanic acid. Acinetobacter, Ctenotrophomonas maltophilia, E. coli (ESBLs) and K. pneumoniae (ESBLs) represented multiple drug resistance. CONCLUSIONS Investigating the distribution and drug resistance of the commonly encountered bacteria is helpful to reasonable and safe application of antibacterials according to different clinical situation, and it is very important for controlling the hospital infection.