综合医院病原菌分布及耐药性分析

Clinical distribution of pathogenic bacteria in general hospital and drug resistance

目的分析综合医院临床各科室病原菌感染部位分布及耐药性。方法对2009年医院临床科室送检病原菌培养标本,采用VITEK-ATB细菌鉴定仪及K-B纸片琼脂扩散法进行菌株鉴定及药敏试验,并对其结果进行统计分析。结果临床细菌送检培养标本主要来源于呼吸道、泌尿道、皮肤与软组织、血液,分别占32.7%、19.7%、19.4%、12.5%;分离出前4位主要病原菌依次为凝固酶阴性葡萄球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌,分别占20.0%、17.6%、16.6%、9.7%;革兰阳性菌中,葡萄球菌属耐药率前3位的是青霉素83.3%、头孢西丁65.3%、红霉素66.2%,链球菌属耐药率前3位的是红霉素49.2%、克林霉素47.7%、青霉素7.7%,肠球菌属耐药率前3位的是红霉素64.8%、四环素62.5%、青霉素33.0%;革兰阴性菌中,大肠埃希菌、肺炎克雷伯菌耐药率前3位的均是氨苄西林85.8%和97.2%、哌拉西林84.6%和64.0%、头孢唑林73.5%和54.2%,铜绿假单胞菌耐药率前3位的是氨苄西林/舒巴坦60.8%、哌拉西林26.5%、替卡西林/克拉维酸24.3%。结论随着病原微生物的变迁及细菌耐药性发生变化,临床及时对患者感染部位进行病原微生物检测及耐药性分析,在感染性疾病诊治及控制医院感染中具有非常重要的意义。

OBJECTIVE To analyze the clinical distribution of the infected sites causing by pathogenic bacteria and drug resistance in general hospital.METHODS The cultured specimens of the pathogens in 2009 were submitted Vitek-ATB automatic bacteria identification devices and KB agar disk diffusion method were applied for strain identification and sensitivity test.The results were statistically analyzed.RESULTS Bacterial culture of clinical specimens submitted the following respiratory tract,urinary tract,skin and soft tissue,blood（formerly 4）,such as specimen-based.The culture-positive rates were 32.7%,19.7%,19.4% and 12.5%,respectively.With the former four were the main pathogens Escherichia coli,Klebsiella pneumoniae,methicillin-resistant coagulase-negative Staphylococci,Pseudomonas aeruginosa.Resistance rate of gram-positive bacteria top three are： Staphylococcus to penicillin 83.3%,cefoxitin,65.3%,erythromycin 66.2%,the top 3 drug resistant rates of Streptococcus to erythromycin 49.2%,clindamycin 47.7% and penicillin 7.7%;Enterococci Erythromycin 64.6%,tetracycline 62.5%,33.3% to penicillin.Resistance rate of gram-negative bacteria the top three are： E.coli,K.pneumoniae and ampicillin were 86.6% and 97.5%,piperacillin 84.6% andcefazolin 73.5% and 54.2% P.aeruginosa resistance rate is three ampicillin/sulbactam 60.8%,piperacillin 26.5%,icarcillin/clavulanic acid 24.3%.CONCLUSION Along with the change of pathogenic microorganisms and bacterial resistance changes,clinical promptly to patients infected parts of pathogenic microorganism inspection and resistance analysis in infectious diseases diagnosis,treatment and control of hospital infection in has the extremely vital significance.