1213例送检标本的细菌谱分析及耐药菌监测

Pathogenic Bacteria in Hospital:Distribution and Drug Resistance of 1 213 Strains

目的了解2003年我院临床感染标本的细菌分布特点,为临床治疗和医院感染的控制提供参考。方法对1 213例临床送检标本分离培养鉴定,同时进行大肠埃希菌和克雷伯菌ESBLs的检测,及耐甲氧西林葡萄球菌(MRS)的测定。结果感染标本革兰阴性杆菌40.9%,真菌33.5%,革兰阳性球菌位20.6%;病原菌感染位居前5位的依次是白色念珠菌、大肠埃希菌、铜绿假单胞菌、热带念珠菌、光滑念珠菌;耐药菌株检测发现耐甲氧西林金黄色葡萄球菌(MRSA)占金黄色葡萄球菌的42.3%;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)占凝固酶阴性葡萄球菌的78.1%;大肠埃希菌和克雷伯菌属中产ESBLs的菌株占47.6%。结论细菌的多重耐药及真菌感染是我院目前面临的重要问题,在临床上应重视细菌培养,合理用药,减少感染。

OBJECTIVE To determine the distribution of bacterial flora in hospital infection and to provide laboratory evidence for controlling hospital infection and selecting rationally antibiotics in clinic practice. METHODS All isolates were identified by routine procedure. MRSA and ESBLs-producing rate of Escherichia coli and Klebsiella pneumoniae were examined. RESULTS Among all these clinical infectious specimens, there were 202 strains of Gram negative bacilli, accounting for 40. 9% （202/495） ; 166 strains of fungi, accounting for 33. 5% ; 621 strains of Gram positive cocci, for 20.6% （102/495）. Candida albicans , E. coli, Pseudomonas aerugionosa , C. tropicalis and C. glabrata took the first five bacteria in infection. Analysis of drug resistant bacteria suggested that the isolated rate of ESBLs-producing strains in Staphylococcus aureus be 47.6%, be CNS in MRCNS 78.1% and MRSA in SA be 42.3 %. CONCLUSIONS Multidrug resistance and fungus infection are the main risk factors in our hospital. We must improve means of treatment on clinical work and use antibiotic rationally to reduce the infection rate.