某院2011～2015年病原菌分布及耐药趋势分析

Analysis of hospital bacteria distribution and drug resistance in 2011-2015

目的了解临床病原菌分布及其对抗菌药物的耐药性,为临床合理用药提供参考。方法对我院2011年1月~2015年12月分离病原菌的流行分布及其耐药性情况进行分析,依据2014CLSI标准判断结果,用WHONET 5.6软件进行数据分析。结果经培养共分离出病原菌8645株,其中革兰阴性菌(G-)6886株(79.7%),革兰阳性菌(G+)1759株(20.3%)。病原菌感染位居前10位的是大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌、流感嗜血杆菌、肺炎链球菌、鲍曼不动杆菌、阴沟肠杆菌、卡他莫拉菌和奇异变形杆菌。革兰阳性球菌中,金黄色葡萄球菌的MRSA检出率为17.4%;肠杆菌科中,大肠埃希菌和肺炎克雷伯菌产超广谱酶(ESBLs)率分别为44.5%和19.7%。对碳青霉烯类耐药的大肠埃希菌和肺炎克雷伯菌分别为0.4%和0.9%;对碳青霉烯类耐药的铜绿假单胞菌和鲍曼不动杆菌分别为18.6%和25.2%;未发现对万古霉素耐药的粪肠球菌和屎肠球菌。结论进行病原学检测,了解病原菌分布及耐药性,对合理使用抗菌药物及减少耐药菌的产生具有重要临床意义。

Objective To analyze the distribution of clinical pathogenic bacteria and it＇s drug resistance and provide laboratory evidence for clinical treatment.Methods Based on the technique of 2014 CLSI,the WHONET 5.6 was used to analyze the data of the distribution and drug resistance of all clinical isolates from the hospital during this 5 years.Results A total of 8645 strains bacteria were isolated,including 6886（69.3%）Gram-negative bacteria and 1759（30.7%）Grampositive bacteria strains.The top 10 bacteria were E.coli,Klebsiella pneumonia,Staphylococcus aureus,Pseudomonas aeruginosa,Haemophilus influenza,Streptococcus pneumonia,Acinetobacter baumannii,Enterobacter cloacae,Moraxella catarrhalis,Proteus mirabilis.In Gram-positive bacteria,Staphylococcus aureus（MRSA）detection rates were 17.4%.In Enterobacteriaceae,E.coli and klebsiella pneumonia bacteria（ESBLs）rate were 44.5% and 19.7%respectively.The rate of E.coli and klebsiella pneumonia with Carbapenems-resistant were 0.4% and 0.9% respectively,but 18.6%Pseudomonas aeruginosa and 25.2% Acinetobacter baumannii were found.There was no E faecium and E faecalis which was resistant to vancomycin.Conclusion It has great significance to investigate and analyze the pathogenic bacteria with their distribution and drug resistance for clinical treatment and reduction of drug resistant.