高原地区感染性疾病细菌分布及药物敏感性分析

Bacterial distribution and drug sensitivities in infectious diseases occurring in plateau area

目的对笔者所在医院内科、外科、妇产科、儿科一年内因感染性疾病住院患者的细菌培养，药敏实验结果进行回顾性调查分析，了解近年来不同科室感染性疾病的病原学趋势以及病原菌对抗生素的敏感性，为医院采购抗生素、临床诊疗及合理使用抗生素提供思路。方法感染性疾病患者的相关标本采用山东鑫科生物科技股份有限公司XK型细菌鉴定／药敏分析仪，对上述四个科室患者病原菌进行鉴定及细菌药物敏感试验。结果所有科室均以G-杆菌为主，占88．5％。其中内科以肺炎克雷伯菌为主，外科、妇产科、儿科均以大肠埃希菌为主，对替卡西林／克拉维酸、头孢哌酮／舒巴坦、亚胺培南、头孢他啶、哌拉西林／他唑巴坦高度敏感，对氨苄西林、头孢唑林、阿莫西林／克拉维酸耐药。G-球菌占11．5％，内科以肺炎链球菌为主，外科、妇产科以表皮葡萄球菌为主，儿科以金黄色葡萄球菌为主，对美罗培南、万古霉素高度敏感，对红霉素、克林霉素耐药。结论本次调查中以G-杆菌为主，应重视抗菌药物的合理使用。

Objective A retrospective analysis was carried out on the results of bacterial cultures and drug sensitivities obtained from patients suffering infectious diseases attended in departments of internal medicine, general surgery, obstetrics and gynaecology, and paediatrics of our hospital over a period of one year. This paper was with the aim of understanding long term trend in the aetiology and pathology of infectious diseases in different departments and antibiotic sensitivities of different bacteria, to provide a reference for rational choice of antibiotics of medical staffs and selection of antibiotics of purchasers. Methods Specimens taken from patients attended in above four departments were analyzed with XK type bacteria identification and antibiotic sensitivity analyzer （Sunko Biotechnology Limited Company, Shandong Province, China）. The results in terms of bacteria identified and their antibiotic sensitivities were recorded and analyzed. Results Gram negative bacteria was the most common in all four departments, accounting for 88.5% in total. Klebsiella pneumoniae was the most common in department of internal medicine, Escherichia coli in departments of general surgery, obstetrics and gynaecology, and paediatrics; which were highly sensitive to ticarcillin/clavulanic acid, cefoperazone/sulbactam, imipenem, ceftazidime, piperacillin/tazobactam, but resistant to ampicillin, cefazolin, amoxicillin/clavulanic acid. Gram positive bacteria accounted for t 1.5%. The most common bacteria in department of internal medicine was streptococcus pneumoniae, staphylococcus epidermidis in departments of general surgery, obstetrics and gynaecology, staphylococcus aureus in department of paediatrics; which were highly sensitive to meropenem and vancomycin, but resistant to erythromycin and clindamycin. Conclusion Gram negative bacteria are the most common in this paper. We should pay attention to rational choice of antibiotics.