阜外心血管病医院临床分离病原菌分布及耐药性

Distribution and drug-resistance of pathogens from clinical samples in a cardiovascular hospital

目的了解某心血管病专科医院临床送检标本分离病原菌的菌群分布及耐药特征,为临床抗感染治疗提供参考依据。方法对该院2009年1—12月临床送检标本分离的病原菌资料进行统计分析。结果共分离1 330株病原菌,其中革兰阴性(G^-)杆菌1 044株(78.49%),革兰阳性(G^+)球菌215株(16.17%),真菌71株(5.34%)。G^-杆菌中以肺炎克雷伯菌居首位(308株),其次为铜绿假单胞菌(205株)、鲍曼不动杆菌(138株)、阴沟肠杆菌(122株)及大肠埃希菌(105株)等。大肠埃希菌和克雷伯菌属产超广谱β-内酰胺酶(ESBLs)的发生率分别为79.00%和41.00%。亚胺培南仍是治疗G^-杆菌感染最有效的药物。金黄色葡萄球菌和凝固酶阴性葡萄球菌中,耐甲氧西林菌株分别占40.00%和98.11%,未发现耐万古霉素的葡萄球菌属和肠球菌属细菌。结论了解临床分离的病原菌及其耐药性,对合理使用抗菌药物,预防和控制医院感染具有重要意义。

Objective To realize the distribution and drug-resistance of pathogens isolated from clinical samples in a cardiovascular hospital , so as to provide reference on clinical anti-infection treatment. Methods The data of clinical pathogens isolated from January to December 2009 were analyzed. Results A total of 1 330 pathogenic strains were isolated, including 1 044 （78. 49%） gram-negative bacilli , 215 （16. 17%） gram positive cocci, and 71 （5.34%） fungi. Gram-negative bacilli mainly consisted of Klebsiella pneumoniae（308 strains） ,Pseudomonasaeruginosa （205 strains）, Acinetobacter baumannii （138 strains）, Enterobacter cloacae （ 122 strains） , and Escherichia coli（105 strains）. The percentage of ESBI.s produced by Escherichia coli and Klebsiella spp. was 79. 00% and 41.00% respectively . Imipenem was the most effective antimicrobial agents for treating gram-negative bacilli. 40. 00% of Staphylococcus aureus and 98.11% of coagulase negative Staphylococcus were methicillin resistant. No Staphylococcus spp. and F.nterococcus spp. strain was found to be resistant to vancomycin. Conelusion Realizing the pathogen and its drug -resistance is very important to prevent and control nosoeomial infections and rational antimicrobial use for clinical treatment.