2013年临床常见病原菌分布及耐药性分析

Distribution and Drug Resistance of Common Pathogenic Bacteria in 2013

目的:了解医院2013年病原菌分布及其耐药性,为临床合理选择抗菌药物提供依据。方法:对2013年医院临床标本细菌鉴定结果及药敏结果进行统计分析。结果:共分离出病原菌1374株,其中革兰阳性菌401株,占29.2%,革兰阴性菌819株,占59.6%,真菌154株,占11.2%。前5位的细菌依次为大肠埃希菌345株,占25.1%,凝固酶阴性葡萄球菌183株,占13.3%,金黄色葡萄球菌156株,占11.4%,克雷伯杆菌138株,占10.0%,鲍曼不动杆菌81例,占5.9%。肠杆菌科细菌对碳青霉烯类抗菌药物高度敏感,耐药率<0.9%,对氨苄西林耐药率较高>78.6%。耐甲氧西林的凝固酶阴性葡萄球菌(MRCNS)和耐甲氧西林的金黄色葡萄球菌(MRSA)分别占75.4%和16.0%。结论:临床分离的病原菌以革兰阴性菌为主,其中大肠埃希菌比例高。革兰阳性菌中耐甲氧西林的凝固酶阴性葡萄球菌所占比例高。分离菌株的耐药现象普遍存在,临床应根据药敏结果合理选用抗菌药物,减少病原菌耐药的产生。

Objective：To investigate the distribution and drug resistance of clinical pathogenic bacteria in 2013 and provide bases for rational of antibiotics.Method：The bacterial indentification results of clinical specimens and the results of drug susceptibility testing performed in 2013 were statistically analyzed.Result：A total of 1374 strains of pathogens were isolated,including 401（29.2%） strains of gram-positive cocci,819（59.6%） strains of gram-negative bacilli, and 154（11.2%） strains of fungi. The Escherichia coli（345 strains）,coagulase-negative Staphylococcus（183 strains）,Staphylococcus aureus（156 strains）,Klebsiella pneumoniae（138 strains）,and Acinetobacter baumannii（81 strains） were the top 5 species of the isolated pathogens,accounting for 25.1%,13.3%,11.4%,10.0%,5.9%.The resistance rates of Enterobacteriaceae against Carbapenem antibiotics, monobactams were less than 0.9%,but more than 78.6% about ampicillin.MRCNS accounted for 75.4%,MRSA accounted for 16.0%.Conclusion：The isolated pathogenic bacteria dominant in the Escherichia coli,which are mainly caused by the gram-negative bacilli.The MRCNS have a big portion in gram-positive cocci.The drug resistance of the isolated pathogenic bacteria is serious,the Susceptibility results should be performed in clinical practice so as to reasonably use antibiotics.