2011-2013年医院感染病原菌分布与耐药性分析

Analysis of bacterial distribution and drug sensitivity of pathogens for nosocomial infections from 2011 to 2013

目的了解医院感染病原菌的主要分布及其对抗菌药物的耐药性,为临床各科感染相关疾病的早期诊断与治疗提供依据。方法对2011年1月-2013年6月医院临床各类标本分离的5 403株病原菌,采用美国德灵公司Microscan-walkaway 96全自动细菌鉴定仪进行鉴定和药敏分析,数据采用SPSS13.0软件进行统计处理。结果临床各类标本中共检出病原菌5 403株,其中革兰阴性菌4268株占78.99%,革兰阳性菌1135株占21.01%;主要革兰阴性菌依次为大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌,分别占18.42%、16.66%、13.18%、11.96%,主要革兰阳性菌依次为金黄色葡萄球菌、表皮葡萄球菌、屎肠球菌,分别占6.61%、4.22%、2.55%;检出的革兰阴性菌对亚胺培南耐药率最低为0-17.80%,革兰阳性菌对万古霉素的耐药率最低为0,病原菌对其他常见抗菌药物的耐药率较高;感染病原菌在科室分布中以重症监护科最多,其次为呼吸科、神经外科、泌尿外科等。结论医院不同科室的主要标本类型和常见菌种有所不同,病原菌对常见抗菌药物的耐药率不同,通过科学检测,为指导临床科室的合理应用抗菌药物提供依据。

OBJECTIVE To investigate the distribution and drug resistance of clinical isolates of pathogens from2011 to 2013so as to guide early diagnosis and treatment of nosocomial infections.METHODS The distribution and the drug resistance of 5403 pathogenic bacteria isolated from clinical samples in Jan.2011- Jun.2013 were analyzed using Microscan-walkaway 96 automatic identifier for identification and drug sensitivity test.RESULTS Of the 5403 isolated pathogenic bacteria,4268（78.99%）were gram-negative and 1135（21.01%）were grampositive.The main gram-negative isolates were 995 Escherichia coli（18.42%）,900 Klebsiella pneumoniae（16.66%）,712 Acinetobacter baumannii（13.18%）,and 646 Pseudomonas aeruginosa（11.96%）.The main gram-positive isolates were 357 Staphylococcus aureus（6.61%）,228 Staphylococcus epidermidis（4.22%）and138 Enterococcus faecium（2.55%）.The resistance of gram-negative strains to imipenem was the lowest,being0-17.80% and the resistance of gram-positive strains to vancomycin was the lowest,being 0.But all the isolates exhibited a high resistance rate to other common antibiotics.The pathogenic bacteria mainly distributed in ICU followed by respiratory department, neurosurgery department, urinary surgery department and so on.CONCLUSION Main clinical specimen types and common isolated pathogenic bacteria are different in different departments,and the resistance rates of main isolates to common antibiotics are different.Therefore,the antimicrobial resistance monitoring should be conducted regularly to guide the rational use of antibiotics in clinical departments.