武汉同济医院血液科病房近5年病原菌分布及耐药性监测

Distribution and antibiotic resistance surveillance of pathogens isolated from hematology wards of Wuhan Tongji hospital in recent five years

目的了解武汉同济医院血液科病房2005-2009年病原菌分布和耐药现状。方法药敏试验采用K-B法,WHONET 5.4软件进行数据分析。结果共分离病原菌667株,革兰阴性菌占54.3%,革兰阳性菌占31.5%,真菌占14.2%;标本主要来源为血液占31.9%,痰液占20.5%和尿液占11.2%,前5位细菌依次为凝固酶阴性葡萄球菌、大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌和白色假丝酵母菌,肺炎克雷伯菌及大肠埃希菌超广谱β-内酰胺酶(ESBLs)阳性率分别为48.9%和79.5%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和耐甲氧西林金黄色葡萄球菌(MRSA)分别占73.8%和26.4%。结论血液病房病原菌以革兰阴性杆菌为主,真菌比例上升较快;主要病原菌耐药现象较前加重。

OBJECTIVE To investigate the distribution and antibiotic resistance of infection pathogens isolated from hematology ward Wuhan Tongji Hospital from 2005 to 2009.METHODS Bacterial susceptibility test was carried out using K-B method.Data were analyzed by WHONET 5.4 software.RESULTS A total of 667 clinical isolates were collected,including Gram-negative bacilli（54.3%）,Gram-positive cocci（31.5%） and fungi（14.2%）.The dominant source of pathogens was blood（31.9%）,sputum（20.5%） and urine（11.2%）.The top five pathogens were Coagulase negative Staphylococcus,Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae and Candida albicans.About 48.9 % of K.pneumoniae and 79.5% of E.coli produced ESBLs.The prevalence of MRSA and MRCNS were 26.4% and 73.8%,respectively.CONCLUSION The most pathogens are Gram-negative bacilli in the hematology ward,the prevalence of fungi increases significantly,and the resistance of major pathogens to most antimicrobial agents is getting worsen.