2009年喀什地区住院患者医院感染病原菌分布及耐药分析

Distribution and antibiotics resistance of pathogens causing nosocomial infections in inpatients in Kashi

目的了解喀什地区住院患者中医院感染病原菌分布及耐药性。方法采用法国生物梅里埃公司全自动细菌培养仪,用MIC法,药敏试剂条为英国Oxoid公司药敏板条。结果 2009年喀什地区3所医院送检各种标本分离菌株1598株,其阳性率30.30%,其中革兰阳性球菌占34.99%,革兰阴性杆菌占55.07%,真菌占8.64%,其他占1.30%;革兰阴性杆菌中大肠埃希菌、肺炎克雷伯菌属对β-内酰胺类产生较高的耐药率分别为70.13%、76.77%;而对碳青霉烯类亚胺培南和美罗培南的敏感率达100.00%,亚胺培南和美罗培南在对革兰阳性球菌中的铜绿假单胞菌、鲍氏不动杆菌保持很好的抗菌活性,其铜绿假单胞菌敏感率分别为87.38%、87.68%,鲍氏不动杆菌分别为96.05%、97.34%;在革兰阳性球菌中凝固酶阴性葡萄球菌占27.29%,未发现万古霉素、替考拉宁、利奈唑胺耐药;肠球菌属占11.99%,有上升趋势,但未检出耐万古霉素肠球菌;金黄色葡萄球菌中的MRSA检出率为58.45%,但未出现万古霉素、利奈唑胺耐药;真菌占8.64%,对氟康唑的耐药性最高达91.60%。结论病原菌的耐药趋势在上升,细菌耐药情况十分严峻,应引起临床医师重视。

OBJECTIVE To investigate the distribution and antimicrobial resistance of pathogens causing nosocomial infections among inpatients in Kashi.METHODS Flora identification and bacteriostatic test were operated with BioMerieux VITEK32.RESULTS In 2009,1598 strains which were firstly isolated from patients from three hospitals in Kashi were collected,the positive rate was 30.3%.The Gram-positive cocci positive rate was 34.99%,the positive rate of Gram-negative bacteria was 55.07%,fungi positive rate was 8.64%,others rate was 1.3%.E.coli and K.pneumoniae possessed high resistance to β-lactam antibiotics were 70.13% and 76.77%,respectively.Imipenem and meropenem remained the most potent antibacterial agents against to P.aeruginosa and A.baumannii,the sensibility of P.aeruginosa was 87.38%,87.68%,respectively,and A.baumannii was 96.05%,97.34%,respectively.Coagulase negative Staphylococcus were the main strains in the isolated Gram-positive cocci,accounting for 27.29%.No strains resistant to vancomycin,linezolid and teicoplanin were detected out.Enterococcus accounted for 11.99%,no vancomycin-resistant Enterococcus were detected;the isolation rate of MRSA was 58.45%,no strains resistant to vancomycin and linezolid were detected;the positive rate of fungi was 8.64%,the resistance rates to fluconazole were 91.60%.CONCLUSION The drug resistance of the pathogens keeps an upward tendency and the the bacterial resistance is very serious,so the clinicians should pay attention to it.