医院分离病原菌分布及药物敏感性分析

Distributions of pathogens isolated from hospital and analysis of drug sensitivity

目的分析临床分离的病原菌分布及不同细菌的药物敏感性,了解细菌耐药的特点,为临床合理使用抗菌药物及有效控制医院感染提供参考。方法细菌培养鉴定及药敏试验采用AMSVITEK仪器分析并结合手工法。药敏试验结果判定按2008年美国临床实验室标准化协会(CLSI)标准进行。利用WHONET软件对临床分离出的388株病原菌分布及其药敏结果进行回顾性分析。结果革兰阳性菌占31.2%,革兰阴性菌占68.8%。分离率较高的依次为为:大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌、奇异变形杆菌、鲍曼不动杆菌、粪肠球菌、阴沟肠杆菌、表皮葡萄球菌、溶血葡萄球菌等。多重耐药菌菌种分布较为广泛,但主要集中于鲍曼不动杆菌、大肠埃希菌、葡萄球菌属、阴沟肠杆菌、铜绿假单胞菌等。结论对临床有较大威胁的主要病原菌是多重耐药鲍曼不动杆菌、产超广谱β-内酰胺酶(ESBL)大肠埃希菌、耐甲氧西林金黄色葡萄球菌、多重耐药阴沟肠杆菌。了解临床分离细菌的分布及耐药情况有助于指导临床合理使用抗菌药物及控制医院感染。

Objective To analyze the distribution of pathogens isolated from Changzhou Cancer Hospital and the drug sensitivity of different bacteria,and understand the characteristics of bacterial resistance to antibiotics and provide a reference for clinical rational use of antibiotics and effective control of nosocomial infections. Methods The identification of bacterial culture and the sensitivity test were used AMSVITEK auto micro-biological system analysis combined with manual method.According to 2008 Clinical and Laboratory Standards Institute（CLSI） standards,the results of drug sensitivity test were judged.The distribution and drug sensitivity results of 388 pathogenic bacteria isolated from the clinical samples were analyzed retrospectively by WHONET software. Results Gram-positive bacteria accounted for 31.2% and gram-negative bacteria for 68.8%.Higher isolated rates were as follows： Escherichia coli,Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella pneumoniae,Proteus mirabilis,Acinetobacter baumannii,Enterococcus faecalis,Enterobacter cloacae,Stapylococcus epidermidis,Staphylococcus haemolyticus and so on.Multi-drug resistant bacteria widely distributed in species,but the main pathogens focused on Acinetobacter baumannii,Escherichia coli,Staphylococcus,Enterobacter cloacae,Pseudomonas aeruginosa and so on. Conclusions The main pathogens causing a greater threat to the patients are as follows： multi-resistant Acinetobacter baumannii,extend-spectrum beta-lactamase（ESBL）-producing Escherichia coli,methicillin-resistant Staphylococcus aureus,multi-resistant Enterobacter cloacae.The distributions of pathgens isolated from hospital and analysis of drug sensitivity play an irreplaceable role in the clinical rational use of antibiotics and effective control of nosocomial infections.