某驻军医院临床分离病原菌现状调查

Investigation of microbial distribution and antibiotic resistance of a station troops hospital

目的研究医院临床分离病原菌的构成及其耐药情况,为合理使用抗菌药物及耐药菌预防控制提供依据。方法采用细菌检验技术,对某驻军医院2014年度住院患者送检标本进行检验与结果分析。结果 2014年度该医院从住院患者送检标本中共分离病原菌2 670株,其中多重耐药菌占病原菌总数的38.02%;革兰阴性菌、革兰阳性菌和真菌检出构成比分别为73.6%、18.2%和13.4%。病原菌中居前5位的依次是铜绿假单胞菌,肺炎克雷伯菌,鲍曼不动杆菌,大肠埃希菌和白色念珠菌。分离率居首位的铜绿假单胞菌对头孢类耐药率达到75%以上,对喹诺酮类、氨基糖苷类和β-内酰胺类较敏感;肺炎克雷伯菌对β-内酰胺酶抑制类及氨基糖苷类抗菌药物较敏感;金黄色葡萄球菌对青霉素耐药率达100%,MRSA及肠球菌中均检出耐万古霉素株。结论该医院临床分离病原菌中以革兰阴性菌为主,多重耐药菌比例较高,对头孢类抗菌药物耐药严重。

Objective To investigate the microbial distribution and antibiotic resistance, so as to provide reference for ra- tional use of antibiotic in clinical practice and help to prevent and control drug resistant bacteria. Methods The bacteria inspection technology was used to investigate the microbial distribution and antibiotic resistance of 2014 in a station troops hospital. Results A total of 2670 bacterial isolates were obtained ,which included 73.6% gram- negative strains, 18.2% gram - positive strains and 13.4% fungus. The strains of higher detection rates included Pseudomonus aeruginosa, Klebsiel- la pneumonia ,Acinetobacter baumannii J^ungus and Escherichia coll. Pseudomonus aeruginosa strains had a high resistance rate of above 75 % to Cephalosporins, but were sensitive to Quinolones, Aminoglycosides and Beta - lactams. Klebsiella pneu- monia strains were sensitive to Beta - lactams and Aminoglycosides. The resistance rate of Staphylococcus aureus to Penicil- lins was 100% and the resistant strains to Vancomyc were found in MRSA and Enterococcus. Conclusion Gram negative bacteria are the main pathogens in the clinical isolates of the hospital. The multi -drug resistant bacteria（MDR） take up the highest proportion at present which have a high resistance rates to Cephalosporins, All these results demonstrate that it is necessary to strengthen monitoring of pathogenic bacteria and prevention and control of key parts.