医院连续9年病原菌分布及耐药性分析

Bacteria Distribution and Drug Resistance over Past Nine Years

目的研究医院临床分离菌对抗菌药物的耐药性特征。方法收集2001-2009年医院住院患者临床分离的病原菌,采用K-B法进行药敏试验,结果判定按CISI标准。结果 2001-2009年共分离病原菌12 015株,其中革兰阴性菌8390株、革兰阳性菌3625株;2001-2009年革兰阳性菌比株分别为28.0%、33.9%、34.9%、39.3%、30.9%、28.6%、27.1%、27.9%、29.9%,2001-2009年革兰阴性菌比株分别为72.0%、66.1%、65.1%、60.7%、69.1%、71.4%、72.9%、72.1%、70.1%、69.8%;MRSA呈上升趋势、凝固酶阴性葡萄球菌基本平衡、ESBLs明显上升,其中产ESBLs大肠埃希菌已经达到60.1%;2009年病原菌分离率由高到低依次为大肠埃希菌(17.6%)、肺炎克雷伯菌(17.3%)、金黄色葡萄球菌(15.1%)、铜绿假单胞菌(12.8%)、其他肠杆菌(9.2%)。结论加强病原菌耐药动态监控,合理使用抗菌药物迫在眉睫。

OBJECTIVE To investigate the antibiotic resistance of clinical bacteria isolated from the hospital. METHODS The pathogens isolated from 2001 to 2009 were analyzed retrospectively. Drug sensitivity experiment was performed by Kirby-Bauer method, the results were determined according to the standard of CLSI. RESULTS There were 12 015 strains of bacteria which were obtained from 2001 to 2009. There were 8390 strains of Gramnegative bacteria and 3625 of gram-positive bacteria. The Gram-positive bacteria rates from 2001 to 2009 were 28.1%, 33.8%, 34. 9%, 39. 3%, 30. 9%, 28. 6%, 27. 1%, 27. 9% and 29. 9%, respectively, meticillinresistant Staphylococcus aureus （MRSA） from 2001 to 2009 kept an upward tendency. There was balance in meticillin-resistant coagulase-negative Staphylococcus （MRCNS）. There was obviously rising in entended spectrum β-lactamases （ESBLs） and the ESBLs-producing Escherichia coli were 60.1%. The top five pathogens were in turn the followings： E. coli （17.6%）, K lebsiella pneumoniae （17. 3%）, Staphylococcus aureus （15.1%）, Pseudomonas aeruginosa （12. 8%） and other Enterobacteriaceae bacteria （9.2%） in 2009. CONCLUSION It is urgent to strengthen the dynamic surveillance to the drug resistance and apply the antibiotics rationally.