广州地区医院脓肿、病灶分泌物及创面感染病原菌群分布与耐药性特点

Identification of Drug Resistant Pathogens Isolated from Abscesses,Body Secrections and Wounds from Patients in Guangzhou

目的了解广州地区临床脓肿、病灶分泌物及创面感染分离病原菌群分布与耐药性特点。方法耐药性监测网成员医院按《全国临床检验操作规程》要求分离临床送检的各种包括脓肿、病灶分泌物及创面的细菌培养标本,药物敏感试验采用纸片扩散法,耐药性数据分析采用WHONET4软件。结果2002-2004年间各种临床标本共分离感染病原菌20087株,其中脓肿、病灶分泌物及创面等标本分离的病原菌2659株,占13.2%。发生脓肿、分泌物及创面感染的患者主要是青壮年,门诊患者占20%。引起脓肿等感染病原菌以革兰阳性球菌为主,占50.5%。其中葡萄球菌的耐药性及耐甲氧西林(MRS)检出率低于其他标本类型分离的葡萄球菌;铜绿假单胞菌对数种抗生素的耐药率比2002全国资料低,差异有统计学意义;大肠埃希菌与肺炎克雷伯菌对所监测抗生素的耐药率则与2002全国资料较为接近。结论不同的标本类型其分离株对抗生素耐药特性有所不同,广州地区引起脓肿、病灶及创面等感染的主要病原菌对抗生素的耐药性一般要比其他标本分离菌低。

Objective To investigate the occurrence and distribution of drug resistant pathogens isolated from abscesses, body secretions and wounds （abbreviated to ABW below）from patients. Method Bacteria were isolated and identified according to the ＂National Clinical Testing Operation Procedures＂. Kirby-Bauer disk diffusion method was used to determine the antibiotic resistance of the bacteria. Result Between 2002 and 2004, a total of 20 087 species of pathogens were isolated, in which 2659 isolates （13.2%） were obtained from ABW. Twenty percent of the patients were out-patients. Gram-positive cocci were the predominant pathogenic bacteria, accounting for 50.5% of the total cases. Staphylococcus from ABW had a lower level of resistance to antibiotics, and also the identification rate of MRS in these samples was lower than those isolated from other sources. According to the published 2002 national antibiotic susceptibility data, the rate of multi-drug resistance of P.aerogenosa was significantly lower than E.coli and K.pneurnoniae. Conclusion There was a variation in the antibiotic resistance among different specimens. The antibiotic resistance of pathogenic bacteria isolated from ABW is lower than the isolates obtained from other sources.