2013—2015年重庆市荣昌区中医院常见病原菌分布及耐药性分析

Analysis on distribution and drug resistance of common pathogens in Chongqing Rongchang District Hospital of TCM from 2013 to 2015

目的了解重庆市荣昌区中医院临床常见病原菌的分布及耐药情况,为临床合理用药提供参考。方法收集重庆市荣昌区中医院2013年9月—2015年9月检验科分离的病原菌及药敏试验结果进行统计分析。结果共分离出病原菌600株,其中革兰阴性菌428株,占71.33%;革兰阳性菌172株,占28.67%。标本主要来自痰液,构成比为75.08%。革兰阳性菌中,葡萄球菌检出率高且耐药较严重,金黄色葡萄球菌敏感的药物有万古霉素、多西环素、阿米卡星和呋喃妥因。未发现耐万古霉素的葡萄球菌。革兰阴性菌中肺炎克雷伯菌对氨苄西林耐药率为100.0%,对其他均敏感;大肠埃希菌对头孢哌酮/舒巴坦钠、哌拉西林/他唑巴坦、亚胺培南较敏感。铜绿假单胞菌、洋葱伯克霍尔德菌和嗜麦芽寡养单胞菌呈现出多重耐药性,对常见抗菌药物均有不同程度的耐药;鲍曼不动杆菌对头孢哌酮/舒巴坦钠、哌拉西林/他唑巴坦、美罗培南、复方新诺明、米诺环素敏感。结论重庆市荣昌区中医院常见病原菌耐药严重,临床应重视病原菌检查,同时加强监管,以降低细菌耐药性。

Objective To investigate the distribution and drug resistance of common pathogens in Chongqing Rongchang District Hospital of TCM from 2013 to 2015, to provide reference for clinical rational drug use. Methods Retrospective investigation was used to analyze the distribution and drug resistance of pathogens in Chongqing Rongchang District Hospital of TCM from September 2013 to September 2015. Results Total 600 strains of pathogens were isolated, in which Gram-negative bacteria were 428 strains （71.33%）. Gram-positive bacteria （172 strains） accounted for 28.67%. The pathogenic bacteria （75.08%） was isolated mainly from sputum samples. In Gram-positive bacteria, staphylococcus had high detection rates and serious resistance. Staphylococcus aureus was sensitive to vancomycin, doxycycline, amikacin, and nitrofurantoin. There was no staphylococcus resistant to vancomycin. In Gram-positive bacteria, the drug resistance rate of Klebsiella pneumoniae against ampicillin was 100.00%, and was sensitive to other antibiotics. Escherichia coli was sensitive to cefoperazone/sulbactam sodium, piperacillin/tazobactam, and imipenem. Pseudomonas aeruginosa, Burkholderia cepacia, and Stenotrophomonas maltophilia presented multi-drug resistance, and were resistant inordinately to common antibiotics. Acinetobacter baumannii was sensitive to cefoperazone/sulbactam sodium, piperacillin/tazobactam, meropenem, cotrimoxazole, and minocycline. Conclusion Drug resistance of pathogenic bacteria is serious in Chongqing Rongchang District Hospital of TCM. It is necessary to pay great attention to the test of pathogen. At the same time, it is important to take effective control measures to reduce the drug resistance of pathogenic bacteria.