山西晋中一院临床常见病原菌分布及其耐药性分析

Analysis of the distribution and drug resistance of the separated clinical common bacteria in Jinzhong first people＇s hospital of Shanxi

目的分析我院2010年全年临床分离病原菌的分布特点及其对常用抗菌药物的耐药情况，为临床用药提供依据。方法采用微生物BioFosun鉴定分析仪对全年临床分离的病原菌970株进行鉴定，并采用WHONET5．4软件进行数据分析。结果共分离革兰阴性杆菌831株（85．7％），主要有铜绿假单胞菌196株（20.2％）、鲍曼不动杆菌147株（15．1％）；革兰阳性球菌139株（14．3％）．主要有金黄色葡萄球菌67株（6．9％）、凝固酶阴性葡萄球菌38株（3．9％）。标本来源以痰标本最多．占82．0％。大肠埃希菌和肺炎克雷伯菌ESBLs的检出率分别为39．8％和41．5％。检出的常见病原菌对抗生索均有不同程度的耐药率。耐甲氧西林金黄色葡萄球菌菌和耐甲氧西林凝固酶阴性葡萄球菌的检出率分别为70．1％和86．9％。未检测到耐万古霉素的葡萄球菌，发现一株耐万古霉素的肠球菌。结论医院感染病原菌的耐药性严重，定期进行病原菌耐药性监测，对指导临床合理应用抗生素和有效控制医院感染有重要意义。

Objective To analyze the distribution and drug resistance of the separated clinical common bacteria in our hospital from January to December in 2010 to provide a basis for the clinical medication treatment. Methods A microbial BioFosun appraisal analyzer were used to evalute the isolated bacteria 970 strains in 2010. The test data were analyzed by the WHONET 5.4 software. Results There were 831 （85.7%） strains gram-negative bacilli main including 196 （20.2%） strains Pseudomonas aeruginosa and 147 （15.1%） strains Acinetobacter baumannii. There were 139（14.3%） strains gram-positive cocci main including 67（6.9%） strains Staphylococcus aureus and 38 （3.9%） strains coagulase-negative Staphylococcus. Most specimens were taken from sputum sources, accounting for 82.0%. The detection rates of ESBLs were 39.8% and 41.5% for Escherichia coli and Klebsiella pneumonia respectively. The resistance rate of isolated bacteria to antibiotics showed different degree. The detection rates of methicillin-resistant Staphylococcus aureus strains and methicillin-resistant coagulase negative Staphylococcus were 70.1% and 86.9% respectively. None vancomycin resistance Staphylococcus was detected. A plant of vancomycin resistance Enterococcus were found. Conclusion The drug resistance of the nosocomial infection bacterial is a serious problem. It is important and urgent to carry out surveillance of bacterial resistance in order to use antibiotics appropriately and to control nosocomial infections effectively.