社区获得性败血症病原菌药敏试验结果分析

Analysis of drug sensitivity test on pathogenic bacteria of community-acquired septicemia

目的对社区获得性败血症的病原菌特点及药敏结果进行比较,为临床治疗提供依据。方法收集2009年1月-2010年12月43例败血症患者送检标本培养分离出的病原菌进行药敏试验分析。结果两年共检出病原菌43株,其中大肠埃希菌占30.2%、肺炎克雷伯菌占18.6%、表皮葡萄球菌占11.6%;大肠埃希菌对20种抗菌药物均存在不同程度的耐药,对氨苄西林、环丙沙星耐药率最高,均达84.1%,对阿米卡星敏感率为69.2%;肺炎克雷伯菌对哌拉西林/他唑巴坦、培氟沙星、加替沙星和氧氟沙星耐药率为0,耐药率最高为氨苄西林,达100.0%;表皮葡萄球菌对20种抗菌药物除哌拉西林/他唑巴坦、氯霉素外,对其他抗菌药物均有不同程度的耐药,耐药率最高为苯唑西林、氨苄西林、阿奇霉素、磺胺甲噁唑/甲氧苄啶,均为80.0%;对比两年大肠埃希菌、肺炎克雷伯菌、表皮葡萄球菌对抗菌药物的耐药率,差异均无统计学意义;2009年与2010年相比,社区获得性败血病的发病率、主要致病菌,差异均无统计学意义。结论医院2009年与2010年社区获得性败血症的主要病原菌构成、病原菌对抗菌药物的敏感性及发病率无明显变化。

OBJECTIVE To provide the basis for the treatment of community acquired septicemia in the future through comparing the pathogenic bacteria features and drug sensitivity results of the patients with community acquired septicemia. METHODS The drug sensitivity results of the pathogenic bacteria from 43 patients with septicemia were analyzed. RESULTS The main pathogens of septicemia were Escherichia coli（30.2%）,Klebsiella pneumoniae（18.6%） and Staphylococcus epidermidis（11.6%）.Escherichia coli came with varying degrees of drug resistance to the tested 20 kinds of antibiotics,whose drug resistance rate to ampicillin and ciprofloxacin could be up to 84.1%.And also its drug resistance rate to amikacin was maximally 69.2%.K.pneumoniae showed no drug resistance to piperacillin/tazobactam pefloxacin,gatifloxacin and ofloxacin,and its maximum drug resistance rate to ampicillin was 100.0%.Apart from piperacillin/taaopbactam and chloramphenicol of the 20 kinds of the tested antibiotics,Staphylococcus epidermidis came with varying degree of drug resistance to the other 18 kinds of antibiotics.Its maximum drug resistance was that to the oxacillin,ampicillin,azithromycin and compound sulfonamide（SMZ＋TMP）,which was 80.0%.Through analyzing and comparing the drug resistance rate of E.coli to the main antibiotics in recent two years,the differences were statistically insignificant.The difference of drug resistance rate of K.pneumoniae to the main drug resistant antibiotic had no statistical significance.And also the same is true of staphylococcus epidermidis.Through analyzing,the difference of incidence of community acquired septicemia between 2009 and 2010 was statistically insignificant.The same was true of the incidence of the main pathogenic bacteria for septicemia in the two years. CONCLUSION The susceptibility of the main pathogens causing community-acquired septicemia pathogens causing community-acquired septicemia has no significant change,and the incidence rate has no significant change as well.