2012-2014年医院感染主要病原菌耐药趋势分析

Trends of drug resistance of main pathogens causing nosocomial infections from 2012 to 2014

目的了解某院医院感染主要病原菌对不同类型抗菌药物的耐药性及其耐药趋势,为指导临床合理选用抗菌药物提供科学依据。方法采用美国BD PhoemixTM100全自动细菌鉴定/药敏分析仪对2012年1月-2014年12月医院感染患者所有送检标本进行细菌鉴定及药敏试验,WHONET5.6软件分析其耐药率,使用SPSS 13.0统计软件进一步分析其耐药变化趋势。结果 3年共检出医院感染病原菌1 202株,检出前5名依次为大肠埃希菌、白色假丝酵母菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌,其多药耐药菌所占比重较2013年有所上升;大肠埃希菌表现出对β-内酰胺类含酶抑制剂敏感性稍差,对哌拉西林/他唑巴坦的耐药率为10.10%~21.40%;肺炎克雷伯菌对阿莫西林/克拉维酸、氨曲南等22种抗菌药物耐药率维持在75.00%以下;金黄色葡萄球菌对氨苄西林、青霉素G耐药率维持较高水平,均〉75.00%,2013年检出2株耐万古霉素金黄色葡萄球菌。结论医院感染主要病原菌耐药率总体维持在较高水平,需进一步加强对细菌耐药性监测,综合分析后合理选用抗菌药物。

OBJECTIVE To understand the trends of drug resistance of the main pathogens causing nosocomial infections to various types of antibiotics so as to provide scientific basis for reasonable clinical use of antibiotics.METHODS All of the submitted specimens were obtained from the patients with nosocomial infections who were treated in the hospital from Jan 2012 to Dec 2014,then the pathogens isolated from the submitted specimens were identified by using BD PhoemixTM100 automatic bacterial identification system,the drug susceptibility testing was carried out with the use of drug susceptibility analyzer,the drug resistance rates were analyzed by using the WHONET5.6software,and the trends of the drug resistance rates were further analyzed by using SPSS 13.0software.RESULTS A total of 1 202 strains of pathogens causing nosocomial infections were isolated;the Escherichia coli,Candida albicans,Klebsiella pneumoniae,Pseudomonas aeruginosa,and Staphylococcus aureus ranked the top five species;the proportion of the multidrug-resistant bacteria showed an upward trend since 2013.The E.coli strains were less susceptible toβ-lactams containing with enzyme inhibitors,and the drug resistance rate to piperacillin-tazobactam varied from 10.10%to 21.40%.The drug resistance rates of the K.pneumoniaeto22 kinds of antibiotics such as amoxicillin-clavulanic acid and aztreonam maintained less than 75.00%.The drug resistance rates of the S.aureus strains to ampicillin and penicillin G were more than 75.00%,and 2strains of vancomycin-resistant S.aureus emerged in 2013.CONCLUSION The drug resistance rates of the main pathogens causing the nosocomial infections generally maintain at high levels.It is necessary to further strengthen the surveillance of the bacterial resistance and reasonably use antibiotics after comprehensive analysis.