临床常见病原菌分布及耐药性分析

Distribution and Drug Resistance of Etiological Germs in Clinic

目的了解2005年昆明市第三人民医院临床感染标本菌体分布及耐药性,为临床治疗和医院感染监控提供帮助。方法按《全国临床检验操作规程》第2版培养分离菌株,用MicroScan WalkAway 40SI微生物自动鉴定仪鉴定菌种和药敏试验。结果共分离细菌1238株,其中真菌48.8%;大肠埃希菌11.1%;甲型副伤寒沙门菌7.5%;肺炎克雷伯菌5.7%;MRSA5.3%;不动杆菌4.7%;铜绿假单胞菌3.9%;MRCNS2.4%;粪肠球菌1.9%;阴沟肠杆菌1.8%等。革兰阳性球菌中未分离出耐万古霉素的菌株,对万古霉素、替考拉宁敏感性高。革兰阴性杆菌分离率高于革兰阳性球菌,对亚胺培南、阿米卡星、哌拉西林/他唑巴坦敏感性最高。结论真菌感染和细菌多重耐药是昆明市第三人民医院的重要问题,要改进治疗手段,合理安全的使用抗生素,以减少真菌和耐药株的发生。

Objective To observe the kinds, distribution and drug resistance of etiological germs in patients of our hospital, and to give help to clinical treatment and control of diseases. Methods Germs isolation and cultivation were carried out according to 《National Clinical Testing Operation Procedures》（2nd edition） and germs definition and resistance test were carried out by using MicroScan WalkAway 40SI. Results 1 238 strains of infectious germs were isolated from the patients in our hospital, including fungus （48.8%）, Escherichia coli （ 11.1% ） , Salmonella paratyhi-A（7.5% ） , Klebsiella pneumoniae（5.7% ） , MRSA（5.3% ） , Acinetobacter（ 4.7% ） , Pseudomonas aeruginose （ 3.9% ） , MRCNS （ 2.4% ） , Enterococous faecalis （ 1.9% ） , Enterobacter cloacae （ 1.8% ）. G^＋ germs were highly sensitive to vancomycin, teicoplanin, no G^＋ germs which are resistant to vancomycin were isolated. G^- germs were highest sensitive to imipenem, amikacin, piperacillin/ tazobactam. G^- germs isolated was much more than G^＋ germs. Conclusion The data in this report showed that fungus infections and germs resistance to antibiotics were the most important issues in the hospital. In order to reduce fungus infection and germs resistance to antibiotics, it is important to improve clinical treatment and use antibiotics reasonably.