2006-2008年间某医院感染病原菌分布趋势及耐药性分析

Distribution Trend and Drug Resistance of Pathogenic Bacteria in A Hospital over the Year 2006-2008

目的对我院2006-2008年间临床分离病原菌分布趋势及耐药性进行分析,为临床合理使用抗生素提供依据。方法利用全自动微生物分析仪对2006-2008年间分离的病原菌进行种属鉴定,并用MIC稀释法进行药敏实验,实验结果采用WHONET5.4软件进行统计分析。结果从2006-2008年间共分离出10238株病原菌,感染标本主要为痰、中段尿及血液;感染菌以G-杆菌为主,占55.5%～74.8%,G+球菌次之,占19.3%～24.8%。2006、2007、2008年度耐甲氧西林金黄色葡萄球菌(MRSA)检出率分别为88.2%、69.3%、64.5%;金黄色葡萄球菌产β-内酰胺酶的检出率分别为85.2%、65.5%、62.0%。大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌ESBLs携带率为24.3%～60.4%。2006-2008年间菌株分布有明显变化。葡萄球菌属对万古霉素的敏感率为100%,位居前五位的G-菌对亚胺培南的敏感率为72.3%～100.0%。结论 2006-2008年间分离的病原菌仍然以G-杆菌感染为主,G+球菌感染次之,但菌谱有明显变化,G+球菌对万古霉素、G-杆菌对亚胺培南具有较高的敏感率。

Objective To investigate the distribution trend and resistence of clinical pathogenic bacteria in a hospital from the year 2006 to 2008 and to provide a rationale behind the rational use of antibacterial agents for clinical practice.Methods All the isolates were identified by VITEK microbe automatic system.Drug susceptibility test was performed by minimal inhibitory concentration method（MIC） in accordance with the CLSI standards and its results were analyzed by the software WHONET 5.4.Resules There were 10238 isolates which were obtained mainly from sputum,middle urine and blood.Isolating rates of Gram-negative and Gram-positive cocci were 55.5% to 74.8% and 19.3% to 24.8%,respectively.The detectable rates of MRSA isolates accounted for 88.2% in 2006,69.3% in 2007,64.5% in 2008 while the rates of β-lactamase-producing staphylococcus aureus was 85.2%,65.5%,62.0%,respectively in the past three years,but the rates of ESBLs-inducing E.colI,Klebsiella pneumoniae and Klebsiella oxytoca were about 24.3% to 60.4%.The major pathogenic isolates were Gram-negative bacilli and all sensitive to vancomycin.The first five Gram-negative bacilli isolates sensitive to imipenem were over 72.3%.Conclusion The three-year pathogenic isolates were still mainly Gram-negativebacilli and Gram-positive cocci were in the second place,but the isolate spectrum had notably changed.The Gram-positive cocci were completely sensitive to vancomycin and Gram-negative bacilli were substantially sensitive to imipenem.