盐步医院2008年细菌耐药性分析

The surveillance of bacterial resistance in 2008

目的了解本院2008年临床分离出的细菌对各类抗菌药物的耐药性,为临床合理应用抗生素提供依据。方法采用法国生物梅里埃ATB-Expression细菌鉴定仪进行细菌鉴定及药敏试验,应用Whonet5.4软件统计耐药率。结果临床分离274株细菌中革兰阳性球菌83株(30.5%),革兰阴性杆菌191株(69.5%);金黄色葡萄球菌和凝固酶阴性葡萄球菌中耐甲氧西林分别占63.2%和80.8%,未发现万古霉素耐药菌株。大肠埃希菌和肺炎克雷伯菌中产ESBLs菌株检出率分别为44.6%和35.7%,各种肠杆菌科细菌和铜绿假单胞菌对亚胺培南敏感,耐药率1.4%～5.9%。结论通过监测临床致病菌的分布特点和耐药性变迁,对指导临床合理使用抗生素,控制医院感染和细菌耐药性发展有重要意义。

Objective To investigate the drug resistance of clinical isolates from our hospital in 2008,and offfer well bases to reasonable use of the medicine in clinic.Methods Use French bio Mérieux ATB-Expression Bacterial Identification System for bacteria identification and antibiotic susceptibility test,and employ statistical software Whonet5.4 to account the resistance rate.Results The Gram-positive bacteria 83 of 274 clinical isolates accounts for 30.5%,while Gram-negative bacteria 191 accounts for 69.5%; Staphylococcus aureus and coagulase-negative methicillin-resistant Staphylococcus accounts for 63.2% and 80.8 % respectively,however, vancomycin resistant strains were not found.Escherichia coli and Klebsiella pneumoniae strains producing ESBLs are 44.6% and 35.7% respectively.Enterobacteriaceae and Pseudomonas aeruginosa are sensitive to imipenem,with the resistance rates of 1.4%-5.9%.Conclusion It is of great importance to guide the rational use of antibiotics in clinic and control the infections within the hospital as well as the bacterial resistance to antibiotics development through mornitoring the distribution of pathogenic bacteria and the clinical characteristics and the changes of drug resistance.