7804株致病菌对抗菌药物的耐药性分析

Analysis on Drug Resistance of 7 804 Stains of Pathogenic Bacteria on Antibiotics

目的:了解青岛大学附属医院(以下简称"我院")送检标本中致病菌的耐药情况,指导临床抗菌药物的合理应用。方法:分析分离出的7 804株致病菌对常见抗菌药物的耐药情况。结果:7 804株致病菌中,菌株数排序居前5位的分别为大肠埃希菌(1 169株,占14.98%)、肺炎克雷伯肺炎亚种(956株,占12.25%)、鲍曼不动杆菌(746株,占9.56%)、铜绿假单胞菌(677株,占8.68%)和金黄色葡萄球菌(469株,占6.01%)。我院检出的革兰阳性球菌主要为金黄色葡萄球菌、表皮葡萄球菌、屎肠球菌和粪肠球菌,尚未发现对替加环素、利奈唑胺耐药的菌株。革兰阴性杆菌主要为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌,除外替加环素,常见的革兰阴性杆菌对不同品种抗菌药物均有一定程度耐药,特殊使用级抗菌药物头孢吡肟、氨曲南、亚胺培南和美罗培南等也有耐药菌株出现。结论:临床致病菌耐药情况日趋严重,应加强医务人员的送检意识及对致病菌耐药性的监测,避免长期经验性用药,应依据药物敏感试验结果并在临床药师的专业指导下应用抗菌药物,以减少耐药菌株的产生,促进抗感染治疗水平的提高及合理用药。

OBJECTIVE：To investigate the drug resistance of pathogenic bacteria samples detected by Huangdao Area of the Affiliated Hospital of Qingdao University （ hereinafter referred to as ＂our hospital＂） , and guide the clinical rational application of antibiotics .METHODS：The drug resistance of 7804 stains of isolated pathogenic bacteria on general antibiotics was analyzed .RESULTS：Among the 7804 strains of pathogenic bacteria , the top 5 bacterial strains were respectively escherichia coli （ 1169 strains, 14.98%）, Klebsiellar pneumonia （ 956 strains, 12.25%）, acinetobacter baumannii （746 strains, 9.56%）, pseudomonas aeruginosa （677 strains, 8.68%） and staphylococcus aureus （469 strains, 6.01%）.The gram-positive cocci detected in our hospital mainly were staphylococcus aureus , staphylococcus epidermidis , enterococcus faecium and enterococcus faecalis , strains resisted to macrodantin , tigecycline , vancomycin and linezolid were not found yet .Gram-negative bacilli mainly included escherichia coli , klebsiella pneumonia , acinetobacter baumannii and pseudomonas aeruginosa . General gram-negative bacilli were resisted to different categories of antibiotics except for tigecycline , drug-resistance bacteria were also resisted to special-use antibiotics including cefepime , aztreonam , imipenem and meropenem .CONCLUSIONS：The drug resistance of pathogenic bacteria was on the rise , the inspection and monitoring of drug resistance of pathogenic bacteria need to be reinforced , long-term empirical medication should be avoided , clinical application of antibiotics should be processed in according to the results of drug sensitivity tests and the specialized guidance of clinical pharmacists , so as to reduce the drug-resistant strains , promote anti-infective therapy and rational medication .