成都市某肛肠医院的678株病原菌分布及耐药性分析

Distribution and drug resistance of 678 strains pathogenic bacteria in a anorectal hospital in Chengdu

目的：了解近2年成都肛肠医院临床分离的病原菌结构和耐药性变迁，为临床抗感染治疗提供依据。方法统计分析2014～2015年患者各类标本分离细菌的鉴定及药敏试验结果。结果近2年间该院分离出的病原菌数目逐年增加，病原菌构成以革兰阴性杆菌为主83．78％，革兰阳性球菌16．22％。药敏结果显示革兰阴性杆菌中，大肠埃希菌菌对第3代头孢耐药率上升；MRSA 对呋喃妥因，万古霉素，复方新诺明等药物则仍比较敏感，其中对万古霉素的敏感性一直保持在100％。结论大肠埃希菌和肺炎克雷伯菌产超广谱β一内酰胺酶 ESBLs 的检出率分别为40．3％和8．9％，碳青霉烯类抗生素是对肠杆菌科细菌抗菌作用最强的药物。 MRSA 对青霉素100％耐药，万古霉素仍是抗 MRSA 有效药物。本院临床病原菌以革兰阴性菌为主，多重耐药菌感染情况比较严峻，临床应严格控制抗生素使用，减少耐药菌株的暴发流行。

Objective Understanding nearly 2 years Chengdu anorectal Hospital clinical isolates of the patho‐gen structure and the change of drug resistance of ,for clinical anti infection treatment to provide the basis .Methods The identification and drug sensitivity test results of all kinds of samples were analyzed by 2014‐2015 .Results In the last 2 years ,the number of pathogenic bacteria isolated from the hospital increased year by year .The main pathogens were gram negative bacilli and 83 .78% gram positive bacteria .16 .22% .Drug sensitivity results showed that the re‐sistance rate of Escherichia coli to the third generation of was increased ,and MRSA was sensitive to vancomycin ,and the sensitivity of vancomycin was still maintained at 100% .Conclusion Escherichia coli and Klebsiella pneumoniae produced a broad spectrum of beta 1 .The positive rate of ESBLs was 40 .3% and 8 .9% ,respectively .MRSA is re‐sistant to penicillin 100% ,and vancomycin is still effective in MRSA .The clinical pathogenic bacteria in our hospital is mainly gram negative bacteria ,the infection of multiple drug resistant bacteria is more severe ,and the clinical appli‐cation should be strictly controlled by the use of antibiotics ,and reduce the outbreak of drug resistant strains .