2012年某院临床分离病原菌分布及耐药性分析

Analysis of the distribution and drug resistance of pathogenic bacteria in clinical isolates of a hospital in 2012

目的 了解2012年延安大学附属医院临床分离病原菌分布及耐药情况,为临床合理使用抗菌药物提供病原学依据.方法 分离菌采用美国Microscan-Walkaway40SI全自动微生物分析仪进行鉴定和药敏试验,用WHO-NET5.6软件进行统计分析.结果 2012-01 ～2012-12共分离出病原菌2271株.其中革兰阳性菌1049株,占46.2％,耐甲氧西林金黄色葡萄球菌（MRSA）、凝固酶阴性葡萄球菌（MRCNS）分别为38.9％、80.6％;革兰阴性菌821株,占36.2％,大肠埃希菌、肺炎克雷伯菌产ESBLS率分别为61.1％、35.5％;真菌399株,占17.6％,以白色念珠菌为主.革兰阳性菌对万古霉素、利奈唑胺100％敏感,对其他抗菌药物均有不同程度耐药;革兰阴性菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南耐药率较低（0～18.6％）;白色念珠菌对7种常用抗真菌药物的耐药率为0～42.3％.结论 葡萄球菌属、白色念珠菌、大肠埃希菌、肺炎克雷伯菌、肺炎链球菌、鲍曼不动杆菌、铜绿假单胞菌、屎肠球菌是本院分离的主要病原菌;病原菌耐药现象较严重,应加强病原菌耐药性监测,以指导临床合理使用抗菌药物.

Objective To study distribution of clinically isolated pathogenic bacteria and drug resistance of Affiliated Hospital of Yanhn University in 2012 Year, For clinical rational use of antimicrobial agents for pathogenic basis. Methods Isolated bacteria identification and drug sensitive tests using the United States Microscan -Walkaway40SI automatic microorganism analyzer, analyzed using WHONET 5.6 statistical software. Results From January 2012 to December 2012, a total of 2271 strains of bacteria were isolated. There were 1049 strains of Gram - positive bacteria, accounting for 46.2% , methicillin- resistant Staphylococcus aureus （ MRSA ） , coagulase negative staphylococcus （ MRCNS ） were 38.9% , 80.6% ; 821 strains of Gram - negative bacteria,accounting for 36.2% ,Escherichia coli, Klebsiella pneumonia producing ESBLS rates were 61.1% , 35.5% ;399 strains of fungi, accounting for 17. 6% ,mainly in Candida albicans. Gram positive bacteria were sensitive to vancomyein, linezolid 100% sensitive, to other antimicrobial drugs have different degrees of resistance ; Gram - negative bacilli to Cefoperazone / sulbactam, piperaeillin/tazobactam, imipenem resistant rate was low （0 - 18.6% ） ;Candida albieans on 7 kinds of drug resistance to commonly used antifungal agents was 0 - 42.3%. Conclusion Staphylococcus species, Candida albicans, Escheriehia coli, Klebsiella pneumoniae, Streptococcus pneumoniae, Bauman Acinetobacter, Pseudomonas aerugino- sa, Enterococeus faecium is the main pathogenic bacteria in our hospital from the;Bacterial resistance phenomenon is more serious,should strengthen the monitoring of drug resistance of pathogenic bacteria,and to guide clinical rational use of antimicrobial agents.