医院常见病原菌的分布及药敏分析

Distribution and drug susceptibility of common clinical isolates of pathogens

目的了解医院2011年常见病原菌的种类分布及其药敏情况,为临床合理用药提供依据。方法细菌培养与鉴定按照《全国临床检验操作规程》进行;药敏试验采用CLSI推荐的K-B法进行。结果 2011年共分离病原菌1960株,其中革兰阳性球菌377株占19.2%,革兰阴性杆菌1254株占64.0%,排名前5位病原菌依次为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、醋酸钙鲍氏不动杆菌、肺炎克雷伯菌,分别占23.9%、17.8%、13.8%、9.2%、6.9%;革兰阳性球菌中金黄色葡萄球菌、粪肠球菌(D群)、屎肠球菌耐药现象比较普遍,但对万古霉素、替考拉宁、利奈唑胺的敏感率为100.0%;革兰阴性杆菌中大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗菌药物敏感率100.0%;对头霉素中的头孢西丁、β-内酰胺酶抑制剂的敏感率均>77.0%,非发酵菌铜绿假单胞菌、醋酸钙鲍氏不动杆菌、嗜麦芽寡养单胞菌的耐药现象比较严重。结论应定期统计分析病原菌分布及药敏情况,使临床医师能够根据病原菌分布、药敏情况、患者生理病理状况制定个体化治疗方案,控制和减少医院感染的发生。

OBJECTIVE To investigate the distribution and drug susceptibility of common clinical isolates of patho- gens in 2011 so as to guide the reasonable use of antibiotics. METHODS The bacteria culture and identification were carried out by referring to the National Clinical Laboratory Procedures, and the drug susceptibility testing was performed by K-B method recommended by CLSI. RESULTS Totally 1960 strains of pathogens were isolated in 2011, among which there were 377 （19.2%） strains of gram-positive cocci and 1254 （64.0%） strains of gram-negative bacilli; the Escherichia coli , Pseudomonas aeruginosa , Staphylococcus aureus, Acinetobacter calcium acetate, and Klebsiella pneumoniae ranked the top five species of pathogens, accounting for 23. 9%, 17. 8%, 13. 8%, 9.2%, and 6.9%, respectively. Among the species of gram-positive bacteria, it was common that the S. aureus, Enterococcus faecalis （D group）,and Enterococcus faecium were drug resistant, the drug susceptibility rates to vancomycin, teicoplanin, and linezolid were 100.0% ; among the species of gram-negative bacteria, the drug susceptibility rates of E. coli and K. pneumoniae to carbapenems were 100.0%, the drug susceptibility rates to the cephamycins such as cefoxitin and β-lactamase inhibitor were more than 77.0% ; among the species of non-fermenting bacteria, the P. aeruginosa, A. calcium acetate, and Stenotrophomonas maltophilia were highly drug resistant. CONCLUSION It is necessary to statistically analyze the distribution and drug susceptibility of the pathogens periodically so as to formulate the personalized treatment program based on the distribution of pathogens, results of drug susceptibility testing, and physiological and pathological status and to reduce the incidence of nosoeomial infections.