3432株临床分离病原菌分布及耐药性分析

Distribution and antibiotic resistance of 3432 clinic isolated pathogenic bacteria

目的了解临床分离病原菌的分布状况及其对常用抗菌药物的耐药情况,指导临床合理用药。方法采用微生物VITEK32鉴定分析仪及相关鉴定卡对全年临床分离菌进行鉴定和药物敏感试验,用LIS系统软件对其结果进行统计分析。结果 2010年5月1日～2011年4月30日笔者所在医院共分离病原菌3432株(真菌除外),其中革兰阴性杆菌2527株,占73.6%,革兰阳性球菌905株,占26.4%。前5位的病原菌为:铜绿假单胞菌805株(23.5%)、大肠埃希菌610株(17.8%)、鲍曼复合醋酸钙不动杆菌401株(11.7%)、金黄色葡萄球菌330株(9.6%)、肺炎克雷伯菌272株(7.9%)。大肠埃希菌和肺炎克雷伯菌产ESBLs的检出率分别为48.0%和24.0%。MRSA和MRCNS的检出率分别为83.3%和77.8%。VRE的比例较高,占肠球菌属的21.5%。结论医院感染病原菌的耐药情况比较严重,应定期对病原菌的耐药性进行监测,以便指导临床合理应用抗生素。

Objective To investigate the distribution and antibiotic resistance of clinic isolated pathogenic bacteria from May 1,2010 to April 30,2011,and instruct the clinic to use drug reasonably.Methods The author Made the identification and antimicrobial susceptibility test of pathogenic bacteria by VITEK 32,analyzed the data with LIS system.Results A total of 3 432 clinical isolates（except fungi）were collected in the whole year,of which Gram-negative bacilli and Gram-positive cocci accounted for 73.6% and 26.4%.The dominant bacteria were Pseudomonas aeruginosa 23.5%（805）,Escherichia coli 17.8%（610）,Acinetobacter baumannii 11.7%（410）,Staphylococcus aureus 9.6%（330）,Klebsiella pneumoniae 7.9%（272）.The detection rate of extended-spectrum beta-lactamases（ESBLs） to E.coli,Klebsiella pneumoniae were 48% and 24%.Methicillin resistant strains in S.aureus（MRSA） and coagulase negative Staphylococcus（MRCNS） accounted for 83.3% and 77.8% respectively.The resistant rate of Enterococcus to vancomycin was high（21.5%）.Conclusion The antibiotic resistance of pathogenic bacteria was severely,it is essential to enhance the drug resistant surveillance so as to guide resonable clinical medicine.