感染暨急救医学内科细菌耐药性监测结果

Surveillance of Drug-resistance in Department of Infection and Critical Care Medicine

目的 调查2002～2004年北京友谊医院感染暨急救医学内科病房临床分离菌耐药性.方法 药敏试验采用纸片扩散法,判定标准根据2001年美国临床实验室标准化委员会（NCCLS）标准判断结果,应用计算机统计软件SPSS进行数据处理.结果 3年中致病菌耐药率呈逐年增高趋势,对克林霉素、头孢吡肟、哌拉西林、庆大霉素、左氧氟沙星等耐药率显著增高具有统计学意义;重症监护病房对广谱抗菌药物耐药问题突出,其中G-杆菌对头孢他啶、头孢吡肟、亚胺培南、奈替米星、头孢哌酮/舒巴坦耐药率显著高于普通病房（P〈0.05）.结论 医院感染和社区感染的病原菌耐药性日益严重,并有逐年增长趋势,应不断进行耐药性监测,合理使用抗菌药物.

OBJECTIVE To investigate the bacterial resistance of clinical isolates from our Department of Infection and Critical Care Medicine from 2002 to 2004. METHODS The drug sensitive test was performed by disk diffusion test, the estimated standards were in accordance with the guideline of National Committee on Clinical Laboratory Standards of the United States. Statistical analysis of data was completed by SPSS software. RESULTS Among total 405 clinical isolates, Gram-positive organisms accounted for 35. 80%, Gram-negative ones were 64.20%. More than 98.00% Gram-positive cocci were sensitive to vancomycin. Gram-negative bacillus＇ drug sensitive rates to imipenem, cefoperazone-sulbactam, and piperacillin-tazobactam were 95. 77%, 93. 75% and 92. 65%, respectively. Drug-resistance rate of pathogens to clindamycin, cefepime, piperacillin, gentamiein, and levofloxacin had shown notable increasing tendency in the three years. The drug-resistance in intensive care unit （ICU） was more serious. The drug-resistance rate of Gram-negative bacilli to ceftazidime, cefepime, imipenem, netilmicin, nitrofurantoin and cefoperazone-sulbactam had reached 32. 71%, 30. 11%%, 10. 91%, 34. 15%%, 48.00%, and 10. 71%, and there was notable difference between ICU and general ward（P〈 0. 05）. CONCLUSIONS The drug-resistance of pathogens in hospital infection and community-acquired infection is deteriorated, and increased year by year. It is necessary to continuously monitor the drug-resistance of bacteria and rationally use antibiotics.