某医院感染性病原菌分布及耐药性分析

Distribution and drug resistance of pathogenic bacteria in hospital

对2012~2014年间某综合医院心脏中心感染性病原菌的构成及细菌耐药性变迁进行回顾性分析,为抗菌药物的合理使用提供依据.以痰液和尿液为主要标本来源,分离出177株病原菌,其中140株革兰氏阴性菌（79.1%）,37株革兰氏阳性菌（20.9%）.主要革兰氏阴性菌为大肠埃希菌（16.9%）、铜绿假单胞菌（15.3%）、肺炎克雷伯菌（14.1%）和鲍曼不动杆菌（12.4%）.主要革兰氏阳性菌为金黄色葡萄球菌（12.4%）.MRSA检出率为72.7%.大肠埃希菌和肺炎克雷伯菌对阿米卡星、亚胺培南和美洛培南的敏感性高;铜绿假单胞菌对阿米卡星和美洛培南的敏感性高;不动杆菌属对包括亚胺培南、美罗培南在内的14种抗生素的耐药率均超过30%,金黄色葡萄球菌对青霉素、喹诺酮类、大环内酯类等大多数抗生素耐药,对万古霉素和替考拉宁敏感.2012~2014年我院心脏中心住院患者感染病原菌中革兰氏阴性菌占优势,病原菌主要来自呼吸道细菌耐药性仍然形势严峻,应加强对细菌耐药性监测.

The composition and trends of drug- resistant bacteria in Heart Center of a hospital were investigated to provide a basis for rational use of antimicrobial drugs. Sputum and urine was the main sources of specimen,and 177 pathogen strains were isolated,including140 Gram- negative bacteria（ 79. 1%） and 37 Gram- positive bacteria（ 20. 9%）. The main Gram- negative bacteria were Escherichia coli（ 16. 9%）,Pseudomonas aeruginosa（ 15. 3%）,Klebsiella pneumonia（ 14. 1%）,Acinetobacter baumannii（ 12. 4%）. The main Gram- positive bacterium was Staphylococcus aureus（ 12. 4%）,and the MRSA detection rate was 72. 7%. Escherichia coli and Klebsiella pneumonia showed high sensitive to amikacin,imipenem and meropenem; Pseudomonas aeruginosa showed high sensitive to amikacin and meropenem. Acinetobacter had resistance rates of more than 30% to 14 antibiotics,including imipenem and meropenem. Staphylococcus aureus had a higher resistance rates to penicillins,fluoroquinolones,macrolides and so on,and was sensitive to vancomycin and teicoplanin. Gram- negative bacteria were dominant in the infection pathogens in Heart Center of China Meitan General Hospital,and mainly came from respiratory pathogens,Bacterial resistance remains a serious clinical problem,and the monitoring should be strengthened.