妇幼保健院妇产科病原体分布特点及耐药性分析

Distribution and Drug resistance of Pathogenic Bacteria in Gynecology and Obstetrics Hospital

目的分析妇幼保健院妇产科2006-2008年感染病原体的分布及耐药特点,指导流行病研究和临床治疗。方法按《全国临床检验操作规程》培养分离菌种,进行细菌鉴定,纸片扩散法进行药物敏感试验。结果共检出病原体3621株,其中支原体属2135株,细菌652株,真菌540株,衣原体属294株;药物敏感试验显示,解脲脲支原体及人支原体对米诺环素的耐药率最低为9.80%;对红霉素耐药率最高为99.60%;白色假丝酵母菌对咪康唑耐药率为5.70%;对氟康唑、伊曲康唑、两性霉素B的耐药率为12.89%-29.30%;金黄色葡萄球菌和表皮葡萄球菌中均未发现万古霉素耐药株;大肠埃希菌和肺炎克雷伯菌对碳青酶烯类高度敏感。结论2006-2008年支原体属在感染性疾病中占重要地位,分离株对常用抗菌药物耐药明显,掌握临床感染常见致病菌的菌群分布及耐药性特点,合理使用抗菌药物,有助于控制医院感染。

OBJECTIVE To investige the distribution and changing pattern of susceptibility of pathogenic bacteria isolated from patients in a gynecology and obstetrics hospital from 2006 throuh 2008 to offer for guiding epidemiological study and clinical trentment.METHODS Flora cultivation and isolation were operated with methods described by the National Clinical Laboratory Operational Regulations.The disk diffusion procedure was used for antimicrobial susceptibility test,Chisquare test was used.RESULTS A total of 3621 strains were isolated.The most frequent isolates were Ureaplasma and Mycoplasma（58.96%）,then Candida albicans,Gram-negative bacilli,Gram-positive cocci,and Chlamydia accounted for 14.97%,9.96%,8.69% and 8.17%,respectively.The result of susceptibility test to antibiotics showed that the rate of drug resistance of Ureaplasma and Mycoplasma to minocycline to mycoplasma was the lowest（9.8%） and the resistance rates to erythromycin was the highest（99.6%）.The drug-resistant rate of C.albicans to miconazole was 5.7%,to fluconazole,itraconazole and amphotericin B was 12.8%,29.3% and 23.1%,respectively.No strains resisant to vancomycin were found in Staphylococcus aureus and S.epidermidis;Klebsiella spp and Escherichia coli wece highly susceptible to carbapenems.CONCLUSIONS Ureaplasma and Macoplasma play an impotant role in infection during 2006-2008.Resistance to the antibacterials is common among all isolates.To grasp the characteristic of flora distribution and drug resistance of pathogenc bacteria could promote the rational use of the antibacterials.It is important to control the hospital infection.