2011-2012年医院感染病原菌分布与耐药性监测

Monitoring on distribution and resistance of bacteria in the hospital from 2011 to 2012

目的了解医院感染病原菌分布及耐药流行趋势,以降低耐药率。方法分析研究2011-2012年在新会区人民医院分离的5 061株病原菌,用ATB Expresion进行病原菌鉴定及药敏试验,并采用IBM SPSS 19软件进行统计分析。结果 2011年临床分离出2 427株病原菌,其中革兰阳性球菌、革兰阴性杆菌、真菌分别占22.0%、63.0%、15.0%;2012年临床分离出的2 634株病原菌中革兰阳性球菌、革兰阴性杆菌、真菌分别占18.8%、64.2%、17.0%;检出率居前5位的病原菌分别依次为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、白色假丝酵母菌、金黄色葡萄球菌;未检测到耐万古霉素金黄色葡萄球菌;2011年铜绿假单胞菌检出率最高,其对氨苄西林/舒巴坦、头孢吡肟、庆大霉素、磺胺甲噁唑/甲氧苄啶的耐药率均>30.0%;2012年大肠埃希菌检出率最高,其对多种抗菌药物的耐药率均>40.0%;对真菌耐药率较低的有两性霉素B及氟胞嘧啶。结论临床病原菌分离总数仍然逐年增高,病原菌耐药状况严峻;应该继续加强监测了解病原菌的分离率,掌握病原菌的敏感性和耐药性数据。

OBJECTIVE To investigate the distribution and resistance of bacterial isolates collected in the hospital so as to reduce resistance rate.METHODS The bacterial isolates collected in Xinhui Hospital Affiliated to Southern Medical University from the year 2011 to 2012were subjected to identification and susceptibility testing by ATB Expresion.The software IBM SPSS 19 was used for statistical analysis.RESULTS Totally 2427 strains of pathogenic bacteria were isolated in the year 2011,including gram-positive coccus（22.0%）,gram-negative bacilli（63.0%）,and fungi（15.0%）.In the year 2012,2634 strains of pathogenic bacteria were isolated,including gram-positive coccus（18.8%）,gram-negative bacilli（64.2%）,and fungi（17.0%）.The detection rate of pathogenic bacteria in the top five were Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,Candida albicans,and Staphylococcus aureus in order.Vancomycin-resistant S.aureus was not detected.In 2011,the detection rate of P.aeruginosa was the highest,with its resistance rates to ampicillin/sulbactam,cefepime,gentamicin,and sulfamethoxazole/trimethoprim all above 30.0%.In 2012,the detection rate of E.coli was the highest,with its resistance rates to a variety of antibacterials all above 40.0%.The fungal resistance rate was lower to amphotericin B and flucytosine.CONCLUSION The total clinical pathogen isolation was still increasing year by year,the status of pathogen resistance was serious.Clinicians should continue to strengthen the monitoring and understanding of isolation rate of pathogens,sensitivity and resistance of pathogenic bacteria.