临床常见病原菌的分布及耐药性分析

Distribution and drug resistance of common pathogenic bacteria in clinic

目的监测医院临床常见病原菌的分布及耐药性,为指导临床治疗提供依据。方法对2011年7月-2012年6月所分离临床常见病原菌分布及耐药性进行分析,采用Microscan WorkAway 40全自动细菌鉴定/药敏分析仪对病原菌进行鉴定和药敏试验,运用WHONET 5.4对药敏结果进行分析。结果临床分离病原菌1926株,革兰阴性杆菌占49.9%,革兰阳性球菌占25.7%,其中革兰阴性杆菌前5位依次为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、阴沟肠杆菌和鲍氏不动杆菌,革兰阳性球菌前3位为凝固酶阴性葡萄球菌、金黄色葡萄球菌和肠球菌属;大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶检出率分别为45.0%和44.6%,耐甲氧西林凝固酶阴性葡萄球菌和耐甲氧西林金黄色葡萄球菌检出率分别为为45.9%和39.6%;革兰阴性杆菌对亚胺培南和阿米卡星较敏感,耐药率均<50.0%;革兰阳性球菌对万古霉素和利奈唑胺非常敏感,耐药率为0。结论临床常见病原菌以革兰阴性杆菌和革兰阳性球菌为主,其对常用抗菌药物耐药率较高,必须加强耐药性监测,指导合理用药。

OBJECTIVE To investigation the distribution and drug resistance of common pathogenic bacteria in clinic, so as to provide useful information for the clinical treatment. METHODS The distribution and drug resist- ance of common pathogenic bacteria isolated during Jul. 2011 to Jun. 2012 was analysed. The species identification and antibiotic resistance tests were performed with the Microscan WorkAway 40 ,and then the result were analyzed with WHONETS. 4. RESULTS A total of 1926 strains of pathogens were isolated, among which 49.9% of them were gram-negative bacilli, and 25.7% were gram-positive cooci. E. coli, K. pneumonia, P. aerugiinosa, A. bau- rnannii and E. cloacae were on the top five position of gram-negative bacilli; Staphylococci aureus and Enterococcus were the top two position of gram-positive cooci. 45 % of the E. coli and 44.6 % of K. pneumonia were tested posi- tive of extended-spectrum β-lactamase. The detection rates of methicillin-resistant coagulase-negaive Staphylococci and methicillin-resistant S. aureus were 45.9% and 39.6%. Almost all of the gram-negative bacilli were sensitive to imipenem,Amikacin etc, and the drug resistance rates were higher than 50.0%; the gram-positive cooci were especially sensitive to vancomycin and linezolid, and the drug resistance rates were 0 %. CONCLUSION Pathogenic bacteria are mainly gram-negative bacilli and gram-positive cooci in clinic. And they have high drug resistance rate to common antibiotics. Drug resistance monitoring should be strengthened in order to instruct rational use of antibiotics.