2012年四川省仁寿县人民医院临床病原菌分布及耐药性分析

Distribution of pathogens and their resistance to antibiotics in the Renshou People`s Hospital during 2012

目的分析我院临床病原菌分布及其对抗菌药物体外抗菌活性，为临床合理选用抗菌药物提供依据。方法对2012年1～12月我院住院和门诊患者送检的12708份标本进行分离培养，采用VITEK2-compact全自动细菌分析仪进行鉴定及药敏试验，用WHONET5．6软件进行统计分析。结果12708份临床标本分离出病原菌2828株。其中革兰阳性球菌432株（占15．3％），革兰阴性杆菌1924株（占68．0％）。革兰阳性球菌中排列前3位的分别是金黄色葡萄球菌204株（7．2％）、肠球菌183株（6．5％）、链球菌属100株（3．5％）；革兰阴性杆菌中肠杆菌科细菌排列前3位的分别是大肠埃希氏菌536株（19．0％）、肺炎克雷伯氏菌328株（11．6％）、阴沟肠杆菌184株（6．5％）。非发酵菌中检出最多的为铜绿假单胞菌348株（12．3％），其次为鲍曼不动杆菌228株（8．1％）。葡萄球菌属中MRSA检出率为40．6％，未发现耐万古霉素和利奈唑胺的葡萄球菌；屎肠球菌和粪肠球菌对万古霉素的耐药率分别为4．8％和1．9％，未发现对利奈唑胺耐药的肠球菌；肠杆菌科细菌对碳青霉烯类抗生素高度敏感；铜绿假单胞菌对亚胺培南耐药率为42．7％，鲍曼不动杆菌对亚胺培南的耐药率为53．2％。结论随着广谱抗生素的广泛应用，细菌耐药性问题日趋严重。临床应结合患者状况及实验室药敏报告结果准确合理用药，避免滥用抗生素以防止细菌耐药性增加。

Objective To analyze the distribution of clinical common pathogenic bacteria in our hospital and their antibacterial activity in order to provide references for clinical choices of antibiotics. Methods 12708 samples from both inpatients and outpatients in our hospital in Jan. 2012 to Dec 2012 were collected and cultured. The identification of bacteria and antibiotics susceptibility tests was performed by using VITEK2-compact automatic biology analysis. The data was analyzed by WHONETS. 6. Results Total of 2828 strains of pathogenic bacteria was isolated from 12708 microbial specimens. Gram-positive cocci were accounted for 15.3% ,and gram- negative bacilli were accounted for 68 %. Among the gram-positive cocci, the top three were staphylococcus anreus （7.2%）, enterococ- cus（6. 5% ） and streptococcus（3.5% ）,respectively. Among the gram-negative bacilli, the most predominant pathogens were Esche- richia coli （ 19. 0% ）, klebsiella pneumonia （ 11.6% ） and enterobacter cloacae （6. 5 % ）. For non-fermenting gram-negative isolates, the most predominant pathogens were pseudomonas aeruginosa（ 12. 3% ） and acinetobacter banmannii （8.1%）. In terms of staphylococcus, the detection rate of MRSA was 40. 6%. For the resistance rate to vancomycin, enterococcus faecium and enterococcus faeealis were 4. 8% and 1.9% ,respectively. There was no resistance to linezolid in enterococcus faecium and enterococcus faecalis. Enterobacteriace- ae was maintained high susceptibility to carbopenems. The resistance rate of pseudomonas aeruginosa to inipenem was 42.7%, and acin- etobacter baumannii to imipenem was 53.2%. Conclusion With the widely use of antibiotics, the resistance of pathogens has become a serious problem. Clinicians should make more reasonable choices of antibiotics according to the patients＂ symptoms and the results of drug sensitivity test to avoid the antibiotics abuse.