我院2008年临床分离菌株分布和耐药趋势与临床对策

Analysis of bacterial distribution and drug resistant tendency and clinical strategy in the civil aviation general hospital in 2008

目的了解我院临床分离菌的分布情况与耐药趋势,为临床合理用药提供建议。方法采用VITEK-2全自动微生物分析仪及纸片扩散法对纳入本次研究的2008年度首次分离的959株致病菌进行鉴定及药敏实验。结果革兰阴性(G-)菌占56.8%(545/959),革兰阳性菌(G+)占43.2%(414/959),耐甲氧西林金黄色葡萄球菌(Methicillinre-sistant staphylococcus aureus,MRSA)占58.8%;耐万古霉素肠球菌(Vancomycin-resistant enterococci,VRE)高达10.5%。G-杆菌中敏感率最高抗生素的为亚胺培南,但铜绿假单胞菌(P.aeruginosa)对其敏感率仅为63.2%。大肠埃希菌(Es-cherichia coli,E.coli)及肺炎克雷伯菌(K.pneumoniae,Kpn)超广谱β-内酰胺酶(Extended-Spectrumβ-Lactamase,ESBLs)检出率分别为44.7%和21%。结论我院临床致病菌耐药情况较为普遍,其中P.aeruginosa与MRSA菌株的多重耐药情况最为严重,经验用药时应引起临床重视。

Objective To investigate the distribution and resistant tendency in the isolated bacteria from the Civil Aviation General Hospital, and to provide professional advice for the rational usage of antibiotics. Methods 959 initially isolated bacteria entered our final analysis in the year of 2008, and the confirmatory identification and antibiotic susceptibility testing were performed on the automatic microbiological analyzer Vitek-2 or by Kirby-Bauer method. Results 56.8% G-bacteria and 43.2% G＋ bacteria made up all isolated bacteria. Multi-drug resistant G＋ coccobacteria detection ratio was high, in which methicilhn resistant Staphylococcus aureus （MRSA） and Vancomycin-resistant entemcocci （VRE） accounted for 58.8% and 10.5 %, respectivdy. Moreover, imipenem and amikaein were the two most susceptible antibiotics currently fighting against G- with their high susceptibility at 93 % and 92%, how- ever, only 66.3 % P. aeruginosa were susceptible to imipenem. ESBLs detection in Escherichia coli and K. pnemnoniae were 44.7 % and 21%, respectively. Conclusion The antibiotic resistance in the hospital was severe, especially for P. aeruginosa and S. aureus, and attention should be paid to the rational antibiotic treatment.