2006年感染病原菌分布特点及耐药性分析

Clinical Distribution of Pathogenic Bacteria and Analysis of Antimicrobial Resistance in Our Hospital in 2006

目的分析医院2006年感染病原菌的分布及耐药性特点,为临床合理使用抗菌药物提供依据。方法细菌鉴定采用法国生物梅里埃公司的VITEK23细菌鉴定仪;药敏试验采用K-B纸片扩散法。结果967株病原菌中,革兰阳性菌326株(33.71%),其中金黄色葡萄球菌113株(11.69%),革兰阴性菌541株(55.95%),其中大肠埃希菌178株(18.41%),真菌100株(10.34%);病原菌的分布以痰液中分离最多,占43.85%,其次为尿液占22.34%,分泌物占10.03%;药敏试验表明,呋喃妥因、万古霉素对常见革兰阳性菌治疗效果较好;头孢他啶、哌拉西林/他唑巴坦、亚胺培南和阿米卡星是治疗革兰阴性菌的首选药物,鲍氏不动杆菌和嗜麦芽寡养单胞菌对常用抗菌药物的平均耐药率为68.20%和64.43%。结论病原菌的多药耐药日趋严重,开展病原菌耐药性监测,对指导临床合理使用抗菌药物,降低医院感染率和病死率有重要意义。

OBJECTIVE To analyze the pathogenic distribution and antimicrobial resistance in our hospital in 2006 and provide the rational information to use antibiotics reasonably. METHODS Flora cultivation and isolation were operated with the methods described by the National Clinical Laboratory Operational Regulations. Flora was identified with the VITEK-32 automatic identifier, and bacteria-susceptibility test was operated with Kirby-Bauer method. RESULTS Totally 967 strains of pathogenic bacteria were isolated; they comprised 326 strains of Gram- positive bacteria, 541 strains of Gram-negative bacteria and 100 strains of fungi. The main Gram-positive microorganisms included Staphylococcus aureus and Enterococcus faecalis, et al. The main Gram-negative microorganisms included Escherichia coli , Klebsiella pneumoniae , Acinetobacter baumannii , Stenotrophomonas maltophilia and Pseudomonas aerugiinosa, et al. Specimen samples mainly isolated from sputum （43.85%）, urine （22.34%）, and secretion （10.03%）. G^＋ microorganisms were sensitive to nitrofurantoin and vancomycin. G^- microorganisms except A. baumannii and S. maltophilia were sensitive to cefoxitin, piperacillin/tazobactam, imipenem, and amikacin; the average resistant rates of A. baumannii and S. maltophilia to antibiotics were 68.20% and 64. 43%, respectively. CONCLUSIONS The severe degree of bacterial multi-drug resistance is increasing, it is urgent to carry out surveillance of bacterial resistance for reasonabe use of antibiotics and decreasing the morbidity rate and the fatality rate.