2009年山东大学第二医院细菌耐药性监测及分析

Bacterial resistance surveillance and analysis in Second Hospital of Shandong University during the year 2009

目的 调查山东大学第二医院2009年临床分离菌株发生率及耐药情况,为临床合理选择抗菌药物提供依据.方法 对2009年山东大学第二医院各类送检标本种类、分布和耐药性进行分析,共计非重复分离株3259株,使用VITEK鉴定系统进行细菌鉴定,纸片扩散法（K-B法）进行药敏试验,微生物检验中文系统ATBPLUS Ver3.3进行数据统计分析.结果 分离菌株主要为革兰氏阴性菌（占56.61%）.大肠埃希菌对青霉素类如哌拉西林、氨苄西林耐药率分别为81.82%、91.92%.对碳青霉烯类抗生素敏感.肺炎克雷伯菌对青霉素类和头孢菌素类、氨基糖苷类等抗生素普遍耐药,未发现对亚胺培南耐药的菌株.铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别达到37.50%和40.69%,鲍氏不动杆菌普遍耐药,只有多肽类抗生素多粘菌素耐药率为1.35%.金黄色葡萄球菌对青霉素类、头孢菌素类、大环内酯类、林可霉素类等多种抗生素耐药率均在80%以上,没有发现耐万古霉素的菌株.结论 我院细菌耐药情况较为严重,应加强合理选择抗菌药物,严格无菌消毒制度,严格控制机会感染和院内感染.

Objective To investigate the Bacterial distribution and antibiotic resistance isolated from the clinical patients in the Second Hospital of Shandong University during the year 2009, and to provide a reasonable choice for rational use of antibiotics in clinical practice. Methods Distribution and drug resistance of a total 3259 non- duplicate isolated specimens in. the Second Hospital of Shandong University in 2009 were analyzed. The VITEK identification system was used for bacterial identification, the drugs sensitivity testing was investigated with the disk diffusion method （KB method）, the data statistical analysis was detected by the micrubiological testing Chinese system ATBPLUS Ver3.3. Results The isolates were mainly Gram - negative bacteria （accounting for 56.61 % ）. The resistance rates of Escheriehia coli to penicillins such as piperacillin, ampicillin were 81.82%, 91.92% respectively, however, sensitive to the carbapenem. Klebsiella pneumoniae was in general resistance to penicillin, cephalosporins, aminoglycosides and other antibiotics, but no resistance to imipenem. Pseudomonas aeruginosa resistance rates to imipenem and mcropcnem were 37.50% and 40.69%, but the peptide antibiotic polymyxin was I. 35%. The resistance rates of Staphylococcus aureus to penicillins, cephalosporins, macrolides, lincomycin and other classes of antibiotics were all above 80%, but found no vancomycin resistant strains. Conclusion Bacterial resistance to antibiotics in our hospital are more serious, reasonable choice of antibiotics and strictly sterile system, strict control of opportunistic infections and nosocomial infections should be strengthened.