2007年临床科室主要病原菌分布和耐药性分析

Distribution and Drug Resistance of Pathogenic Bacteria in Clinical Departments in 2007

目的：分析2007年临床科室医院感染主要病原菌的分布及耐药趋势，为指导临床合理应用抗菌药物及控制医院感染提供依据。方法：对2007年1月至12月临床科室388例送检标本中分离的病原菌的分布和耐药性进行统计和分析。结果：共分离203株病原菌，其中真菌37株（18.23％）；革兰阳性球菌50株（24.63％），以葡萄球菌为主，耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌分别占66.7％和72.4％，未发现耐万古霉素菌株；革兰阴性杆菌116株（57.14％），以大肠埃希氏菌、铜绿假单胞菌、阴沟肠杆菌、肺炎克雷伯氏菌、不动杆菌和变形杆菌为主，产ESBLs的大肠埃希氏菌和肺炎克雷伯氏菌为84.0％和80.0％。革兰阴性菌对碳青霉烯类耐药率最低，对部分抗菌药产生多重耐药。结论：医院感染病原菌耐药性严重，定期进行耐药性监测，对指导临床合理应用抗生素和有效控制医院感染有重要意义。

Objective：To analyze the tendency of bacterial distribution and resistance of hospital infections in 2007, and to provide the reference for the clinical treatment and infection control in hospital. Methods：A total of 203 pathogens strains from clinical departments during Jan to Dec 2007 were completely surveyed and analyzed. Results： Among them 37 strains were fungi （18.23%） , the rate of fungus infection is very high. There were 50 strains of Gram - positive cocci （24.63%） , the most common pathogens of them were Staphylococcus. Meticillin resistant strains of Staphylococcus auras and coagulase negative Staphylococcus （CNS） accounted for 66.7% and 72.4% , respectively. In our data, no vancomycin resistant S. aureus were isolated. There were 116 strains of Gram negative bacilli （57.14%） , the most common pathogens of them were Escherichia coli , Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella pneumoniae, Aeinetobacter species and Proteus species. The ESBLs producing strains of E. coil and K. pneumoniae accounted for 84.0% and 80.0% , respectively. The highest susceptible to Gram - negative bacilli was carbapenem. Mainly pathogens bacteria were multi - resistant to some antibiotics. Conclusions ： Drug resistance of the nosocomial infection bacteria is a serious problem. It＇s important and urgent to carry out surveillance of bacterial resistance for appropriate using of antibiotics and effective controlling nosocomial infections.