4754株临床分离菌菌群分布和耐药性分析

Flora Distribution and Analysis of Drug Resistance of the 4754 Clinical Isolated Bacteria Strains

目的:了解云南云溪地区临床分离菌的菌群分布和耐药情况,指导合理用药。方法:对我院1999-2001年从血液、体液、尿液、口痰、阴拭子和粪便标本中分离的4754株病原菌作回顾性分析。结果:革兰阴性杆菌比例显著升高,条件致病菌和酵母样真菌检出机会显著增多;药敏结果显示多数临床细菌对常用抗生素的耐药趋势在不断上升;大肠埃希菌、沙门菌和枸橼酸杆菌等革兰阴性杆菌对喹诺酮类药物的耐药率达57％-97％,亚胺培南则对阴性杆菌有较高的敏感覆盖率;耐甲氧西林葡萄球菌(MRS)对环丙沙星、诺氟沙星、氯洁霉素、四环素、红霉素、头孢唑啉和氨苄西林的耐药率分别为 40．9％、42．4％、63．6％、70．2％、85．9％、100．0％和100．0％;链球菌和肠球菌对多数β内酰胺类青霉素、氨基糖苷类、大环内酯类、四环素类以及磺胺类药物均呈高度耐药,耐药率在36％-100％。结论:临床抗生素应用中的耐药性问题十分严峻,应定期监测区城内细菌的耐药变化,指导临床合理用药。

Objeaive： To study the flora distribution and investigate drug resistance of clinical isolated bacteria in Yuxi city for the guidance of rational use of antibiotics. Methods： A retrospective analysis was made on a total of 4754 strains of pathogens separated from blood, body fluid, urine, sputum, vaginal secreta and stool samples from 1999 to 2001 years in Yurd municipal people＇s hospital. Results： The proportion of Gram-negative bacilli rose obviously, so did the opportunistic pathogen＇s and Yeasts detected rate. Most drug sensitive tests showed the drug-fast rate turned to be high. Escherichia coli, Salmonella and Citrobacter resistant and so on to fluoroquinolones was 57% ~97%. These bacteria to imipenem showed excellent activity. Meticillin-resistant-staphylococcus （MRS） resistant to ciprofloxacin, norfloxacin, clindamyein, tetracycline, erythromycin, cefazolin and ampicillin were 40. 9%, 42. 4%, 63. 6%, 72. 2%, 85. 9%, 100. 0% and 100. 0% ,respectively Streptococcus and Enterococeus resistant to major β-lactams-penicillin,aminoglycosides, maerolides, tetracyclines and sulfonamides were between 36. 0% to 100. 0%. Conehtsion：The situation of clinical antibiotic resistance is quite serious, the bacteria＇s drug resistance dynamics in our responsible region should examine constantly, so to guide doctors using drugs reasonably.