普通外科患者感染的病原菌分布及耐药性分析

Distribution and drug resistance of pathogens isolated from general surgery department

目的实时监测和回顾性分析普外科患者感染细菌的种类和对抗菌药物的敏感率,以指导临床合理用药。方法应用VITEK-AMS系统对2006年1月-2010年12月医院普外病区患者病原菌进行分离、鉴定及药敏试验,并对资料进行统计分析。结果 5年共检出412株病原菌,以革兰阴性杆菌为主,占79.85%,革兰阳性球菌占20.15%,大肠埃希菌居首位,占35.92%;肺炎克雷伯菌次之,占13.59%,其后为奇异变形菌、丙二酸盐阴性柠檬酸杆菌、鲍氏不动杆菌、铜绿假单胞菌、溶血葡萄球菌、粪肠球菌、金黄色葡萄球菌及表皮葡萄球菌等;产ESBLs大肠埃希菌检出69株,检出率为46.62%,产ESBLs肺炎克雷伯菌检出14株,检出率为25.00%;大肠埃希菌对8种抗菌药物敏感率>50.00%。结论长期监测普外科病区病原菌种类及对抗菌药物的药敏率的变化,从而指导临床合理选择应用抗菌药物是非常重要的。

OBJECTIVE To perform the real-time monitoring and retrospective analysis of the distribution and drug susceptibility of pathogenic bacteria isolated from general surgery wards and guide rational administration of antibiotics. METHODS The pathogenic bacteria from patients were isolated and identified, the drug susceptibility testing was performed in general surgery department from Jan 2006 to Dec 2010 with VITAK-AMS system. The statistical analysis was conducted on the data. RESULTS A total of 412 strains of pathogenic bacteria were isolated during the past 5 years, among which gram-negative bacilli （79.85 %）were the most common pathogens, followed by gram-positive cocci （20.15 % ） ; Escherichia coli ranked the first place （35.92 % ）, followed hy K lebsiella pneu- moniae （13. 59%）, next were Proteus mirabilis, malonate-negative citric acid bacillus, bowman/haemolysis stato-bacillus, Pseudornonas aeruginosa, Staphylococci haemolysis, Enterococcus faecalis, S. aureus and S. epidermidis; there were 69 strains of ESBLs-producing E. coli with the detection rate of 46.62%, there were 14 strains of ESBLs-producing K. pneumoniae detected with the detection rate of 25.00%; the drug susceptibility rates of E. coli to 8 antibiotics were higher than 50.00%. CONCLUSION Long-term surveillance for the species of the pathogens and the change of drug susceptibility rate is crucial to the reasonable use of antibiotics.