2007-2009年医院常见细菌的分布与耐药性监测

Distribution of common pathogenic bacteria in hospital and surveillance to drug resistance 2007-2009

目的调查基层医院常见细菌分布及耐药性,为临床合理使用抗菌药物提供科学依据。方法对2007-2009年临床各类标本培养分离的细菌分布、构成和耐药性进行回顾性分析和统计。结果共分离出细菌1922株,其中革兰阴性杆菌1424株,占74.1%;革兰阳性球菌498株,占25.9%;分离前6位依次是大肠埃希菌、鲍氏不动杆菌、金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌及表皮葡萄球菌;产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌分别为46.5%和30.2%;耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌分别为39.4%和40.9%,未发现耐万古霉素葡萄球菌;革兰阴性杆菌对碳青霉烯类最敏感,革兰阳性球菌对万古霉素耐药率最低。结论坚持细菌耐药性监测,及时报告给临床,对指导临床合理有效地应用抗菌药物,积极控制细菌感染具有重要意义。

OBJECTIVE To investigate the pathogen distribution and drug resistance,to provide the scientific basis for the rational use of antimicrobial drugs.METHODS The distribution,composition and drug resistance of the pathogens isolated from clinical specimens during 2007-2009 retrospectively analyzed.RESULTS A total of 1922 strains of pathogenic bacteria were isolated,among which Gram-negative bacteria were 1424（accounting for 74.1%）,498 Gram-positive cocci accounting for 25.9%.The top 6 bacteria were Escherichia coli,Acinetobacter baumannii,Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella pneumoniae and Staphylococcus epidermidis.Extended spectrum β-lactamase（ESBLs） producing E.coli and K.pneumoniae were 45.4% and 30.2%,respectively.Methicillin-resistant S.aureus（MRSA） and coagulase-negative staphylococci（MRCNS） were 39.4% and 40.9%,Vancomycin-resistant Staphylococcus was not found;Gram-negative bacilli were most sensitive to carbapenem,the drug resistant rates of Gram-positive cocci to vancomycin were the lowest.CONCLUSION To adhere to bacterial resistance monitoring and timely report to the clinics have great importance in directing the rational application of antibiotics and effectively controlling the bacterial infection.