4925株医院感染细菌分布及耐药性分析

Distribution and drug resistance spectrum analysis of 4925 clinical isolates of bacteria

目的分析4 925株临床分离病原菌的分布及耐药性,为临床合理使用抗菌药物提供依据。方法采集2009年1～12月医院感染的各种标本,常规分离、培养,采用VITEK-2全自动细菌分析系统进行细菌鉴定及药敏测定,以美国临床实验室标准化研究所(CLSI)2008年版为判断标准,应用WHONET5.4软件进行数据分析。结果革兰阴性杆菌3 395株(68.9%);革兰阳性球菌1 530株(31.1%)。出现产碳青霉烯酶的肺炎克雷伯菌(KPC)、鲍曼不动杆菌、铜绿假单胞菌泛耐药菌株。结论临床常见病原菌中以革兰阴性杆菌为主,碳青霉烯类抗生素对肠杆菌科细菌仍保持最高活性。临床病原菌耐药性比较严重,应加强监测,指导临床合理使用抗菌药物。

Objective Analyze the pathogen distribution and antibiotic resistance of the 4 925 pathogenic bacteria in our hospital,based on the rational using antibiotics for the clinical therapy.Methods The Identification and susceptibility to antibiotics of 4 925 pathogenic bacterias were tested by VITEK-2.Drug susceptibility testing was performed methods recommended by CLSI（2008）.Data was analyzed by WHONET5.4 software.Results A total of 4 925 pathogenic bacterias were collected in 2009,including 3 395（68.9%）strains of gram-negative bacilli and 1 530（31.1%）strains of gram-positive cocci.Some Enterobacteriaceae which produced KPC enzyme were found and resistant to hydrocarbon mold vinyl antibiotics.Some pan-resistant pathogenic bacteria were identified in Pseudomonas aeruginos,Acinetobacter baumanii.Enterococci and Staphylococcal strain was not found resistant to vancomycin.Conclusion The rate of gram-negative bacilli is still the highest.For Enterobacteriaceae carbapenemase are still highly active.Antimicrobial resistance in clinical bacterial isolated is a serious problem in our hospital.Antimicrobial agents should be used rationally based on the results of susceptibility testing.