败血症患者细菌耐药情况分析及用药对策

Analysis of bacterial drug resistance and drug countermeasures in patients with septicemia

目的 分析败血症患者的细菌耐药情况及用药对策，为进一步规范临床用药提供依据。方法 回顾性分析本院2012年5月～2013年10月临床确诊的160例败血症住院患者的临床资料，考察其病原菌的分布，采用Kirby—Bauer纸片扩散法进行药敏试验，最终结果 以美国临床实验室标准委员会（NCCLS）标准判断。结果 共检出细菌112株，革兰氏阳性菌74株（66．1％）、革兰氏阴性菌38株（33．9％），前者以金黄色葡萄球菌为主，占34．8％，后者以大肠埃希菌为主，占13．4％。对常用的抗菌药物均呈现出较高的耐药率，只有万古霉素和亚胺培南分别对金黄色葡萄球菌和大肠埃希菌敏感性高。结论 开展细菌耐药性监测、控制耐药菌株发展，可为临床合理应用抗菌药物提供依据。

Objective To analyze the bacterial drug resistance and drug countermeasures in patients with septicemia,to provide a basis for further standardize clinical medicine.Methods The clinical data of 160 cases of patients with septicemia who were diagnosed in our hospital from May 2012 to October 2013 were analyzed retrospectively.The distribution of pathogens was investigated,and Kirby-Bauer disk diffusion was used for susceptibility testing.Eventually results were judged according to the United States Committee for Clinical Laboratory Standards （NCCLS）.Results 112 strains were detected,which contained 74 strains （66.1%） Gram-positive bacteria and 38 strains （33.9%） Gram-negative bacteria.The former were mainly on Staphylococcus aureus,accounting for 34.8%;the latter were mainly on Escherichia coli, accounting for 13.4%.Most of them showed high resistance rates to commonly used antibiotics,only Vancomycin and Imipenem were sensitive to Staphylococcus aureus and Escherichia coli,respectively.Conclusion It provides a basis for rational use of antimicrobial drug to carry out detection of bacterial resistance and control the development of resistant strains.