2002年~2004年上海市胸科医院临床分离细菌及其敏感性分析

The Clinically Isolated Strains in Shanghai Municipal Chest Hospital during2002～2004and the Antimi-crobial Susceptibility Analysis

目的：了解2002年～2004年上海市胸科医院感染病原体的构成及耐药谱的动态变化。方法：应用MicroScan W／A-40细菌鉴定系统，对2002年～2004年中送检的各类标本所分离的菌株进行鉴定及药敏测定。结果：所检出的前5位菌株3年均为肺炎克雷伯杆菌、铜绿假单胞菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌和白色念珠菌。真菌感染呈明显上升趋势，从2002年的第3位上升到2003年、2004年的第1位。不论是革兰阴性杆菌还是阳性球菌，其耐药性均有不同程度增加。亚胺培南、关罗培南对革兰阴性菌的耐药率较低，万古霉素对革兰阳性菌的耐药率最低。结论：我院病人中分离的细菌耐药水平高且多重耐药，应该了解各菌种的耐药特点和耐药机制，严密监控新的耐药菌的产生。

OBJECTIVE：To investigate the composition of pathogens and the dynamic change of drug - resistant strains m Shanghai municipal chest hospital during 2002-2004. METHODS： The isolated strains from all the specimens sent for examination during the 2002-2004 period in our hospital were identified using MicroScan W/A-40 bacteria identification system, meanwhile the drug sensitivity analysis was carried out.RESULTS：For the 3 consecutive years, the leading 5 places on the list of the detected stains were klebsiella spp, pseudomonas aeruginosa, coagulase negative staphylococcus, staphylococcus aureus and candida albican, respectively.The fungus infection was obviously on the rise, and it has forced its way into first place in 2003 and 2004 from the third place in 2002.The drug resistance of both gram - negative bacteria and gram - positive bacteria increased to some extent. Imipenem and meropenem showed low drug resistance to gram - negative bacteria and vancomycin was the least drug - resistant to gram - positive bacteria.CONCLUSION：The microorganisms isolated from patients in our hospital are highly drug- resistant and multidrug resistant.Knowledge about the features and the mechanism of drug resistance of all the strains should be mastered and the new drug-resistance bacteria should be strictly monitored.