685株病原菌分布及药物敏感性分析

Distribution of 685 Strains of Pathogenic Bacteria and Analysis of Drug Sensitivity

目的了解医院病原菌分布及耐药情况,为临床合理使用抗菌药物提供科学依据。方法细菌培养鉴定及药物敏感性试验采用VITEK-AMS仪器分析并结合手工法,药物敏感性试验结果判定按2008CLIS相关标准进行。利用WHONET软件对医院2010年1月至2011年6月期间住院患者标本分离出的685株病原菌分布及其药物敏感性试验结果进行回顾性分析。结果革兰阴性杆菌占48.90%,革兰阳性球菌占27.30%,真菌占23.60%。未发现耐万古霉素菌株。分离率较高的为大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、真菌。多药耐药现象主要集中在大肠埃希菌、鲍曼不动杆菌、葡萄球菌属、铜绿假单胞菌、肺炎克雷伯菌。结论鲍曼不动杆菌、铜绿假单胞菌、产超广谱β-内酰胺酶(ESBLs)大肠埃希菌、耐甲氧西林金黄色葡萄球菌、肺炎克雷伯菌、真菌是医院常见致病菌共占致病菌检出率的81.81%,应将其作为该院主要监测的目标细菌。

Objective To understand the distribution of pathogens and their drug resistance in our hospital to provide a scientific basis for the rational use of antimicrobial drugs.Methods Bacterial culture and identification,and the drug sensitivity test used the VITEK-AMS automicro-biological system combined with the manual method.According to 2008CLIS relevant standards,the results of drug sensitivity test were judged.The distribution and drug susceptibility results of 685 pathogenic bacteria isolated from clinical samples in our hospital from January 2010 to June 2011 were analyzed retrospectively by WHONET software.Results Gram negative bacilli accounted for 48.90%.Gram positive cocci accounted for 27.30%.And Fungi accounted for 23.60%.While vancomycin-resistant strains were undetected.The higher isolated rates were as follows：Escherichia coli,Staphylococcus aureus,Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa and fungi.The phenomena of multidrug resistance mainly concentrated in Escherichia coli,Bauman Acinetobacter,Staphylococcus,Pseudomonas aeruginosa and Klebsiella pneumoniae.Conclusion Acinetobacter baumannii,Pseudomonas aeruginosa,ESBLS-producing Escherichia coli,methicillin-resistant Staphylococcus aureus,Klebsiella pneumoniae and fungi are common pathogenic bacteria in our hospital.And the six kinds of bacteria account for 81.81%in the detection rate of pathogenic bacteria.Therefore,these bacteria should be acted as the main monitoring target bacteria in our hospital.