1641株临床分离病原菌的分布及耐药分析

Analysis of the distribution of the pathogenic germs separated in clinic and its drug resistance

目的了解重庆市涪陵中心医院2006～2008年临床分离病原菌的分布情况及常见细菌的耐药现状。方法对2006～2008年临床科室送检的培养标本,采用MicroScan A/s-4自动细菌鉴定及药敏测试仪进行鉴定和药敏试验,并对其结果进行统计分析。结果 4621份标本共分离出的病原菌占34.93%,其中以革兰阴性杆菌为主。检出前5位的病原菌依次为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌。送检标本主要以痰、血液、脓、尿液为主。耐甲氧西林的金黄色葡萄球菌(MRSA)的检出率为55.74%;产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌的检出率分别为36.55%、26.38%;铜绿假单胞菌和鲍曼不动杆菌是多重耐药菌株,对多种抗菌药物耐药。结论本院分离的细菌耐药水平高且多重耐药,加强病原菌的耐药性监测,有利于合理使用抗菌药物和减缓多重耐药菌株的形成。

Objective To realize the distribution of the pathogenic germs collected from our hospital and the drug resistance of common bacteria in 2006-2008. Methods The implement identification was conducted by using MicroScan A/s-4 auto bacterial identification system and susceptibility test by using susceptibility test instrument on cultured samples submitted clinically from 2006 to 2008,and at the same time,the results were analyzed. Results The pathogenic bacteria separated from 4621 samples occupied a proportion of 34.93%,which are mainly gram negative bacilli. The detected top 5 pathogenic germs were successively Escherichia coil,Pseudomonas Aeruginosa,Klebsiella Pneumoniae,Staphylococcus Aureus and Acinetobacter Baumannii. The submitted samples were mainly sputum,blood,purulence and urine. The detectable rate of Methicillin Resistant Staphylococcus Aureus （MRSA） reached by 55.74%; the detectable rates of Escherichia coil of Extended Spectrum β-lactamases （ESBLs） and Klebsiella Pneumoniae are 36.55% and 26.38% respectively;the Pseudomonas Aeruginosa and the Acinetobacter Baumannii are multi-drug resistant bacteria,which show drug resistance to many antibacterial drugs.Conclusion The bacteria separated by our hospital have high drug-resistance levels and are of multi-drug resistance.In order to strengthen the detection of the drug-resistance of pathogenic germs,it is favorable to use antibacterial drugs reasonably and reduce the formation of multi-drug resistant bacterial strains.