临床分离病原菌变迁及耐药状况分析

The Change of Clinically Isolated Pathogenic Bacteria and Their Drug Resistance Pattern

目的了解8年医院临床分离病原菌构成及耐药变迁情况。方法对2001～2008年临床分离的14428株病原菌及耐药情况进行回顾性调查并做统计分析。结果临床分离的病原菌革兰阴性（G^-）杆菌占65．09％，主要以大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌、肺炎克雷伯菌及不动杆菌属多见；革兰阳性（G^＋）球菌以凝固酶阴性葡萄球菌为主，占38．13％；真菌占18．39％；G^-杆菌对临床常用抗菌药物均有不同程度耐药，对氨苄两林普遍耐药率高；对亚胺培南、哌拉两林／他唑巴坦、阿米卡星耐药率较低；葡萄球菌属对β-内酰胺类等抗菌药物耐药率高，对万古霉素的敏感率达100．0％。结论临床分离病原菌构成及耐药谱在不断发生变化，临床医师应掌握细菌及耐药性变化动向，提高抗菌药物合理使用水平。

OBJECTIVE To comprehend the changes in the spectrum of clinically isolated pathogenic bacteria and their drug resistance during the last eight years. METHODS Totally 14428 pathogenic bacteria isolated from clinical samples of the inpatients in our hospital during from 2001 to 2008 and their drug resistance was statistically analyzed retrospectively. RESULTS The most of clinically isolated pathogenic bacteria were Gram-negatives （65. 09%）, the most common pathogens of them were Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloacae ,Klebsiella pneumoniae and Acinetobacter. Among Gram positive cocci,the isolation rate of coagulase negative staphylococci was 38.13%, which was the highest. Fungi were 18.39 %. Gram-negative bacilli were resistant to commonly used antibacterials in different degrees, especially to ampieillin, but to imipenem, piperacillin/tazobactam and mikacin were low. The drug resistance rates of staphylococci to β-lactams were high, and to vancomycin reached 100%. CONCLUSIONS The spectrum of clinically isolated pathogenic bacteria and their drug resistance patterns are changing continuously. Doctors must pay attention to the bacteria drug resistance, so as to know the change in bacteria and the change in their drug resistance,and improve the application of antibiotics at last.