临床微生物以及细菌耐药性检验在临床合理用药中应用效果分析

Analysis of application effect of clinical microbiology and bacterial resistance test in clinica rational drug use

目的：探讨临床微生物及细菌耐药性检验的应用意义.方法：选取2016年1月～12月在我院分离出的824株菌株,采用全自动细菌鉴定药敏分析仪和纸片扩散法进行鉴定和药敏试验.结果：824株病原菌中革兰阳性菌和革兰阴性菌分别占38.71％和56.80％;革兰阳性菌中以金黄色葡萄球菌、 肺炎链球菌和肠球菌属为主,革兰阴性菌中以大肠埃希菌、 铜绿假单胞菌和克雷伯菌为主;金黄色葡萄球菌对红霉素及青霉素G耐药率均〉80％,肺炎链球菌对红霉素和四环素耐药率均〉80％;大肠埃希菌对氨苄西林及哌拉西林耐药率均〉80％,铜绿假单胞菌耐药率普遍较低;824株病原菌中共检测出128株多重耐药菌株,占15.53％,ICU和外科多重耐药菌构成比较分别为20.25％和18.85％,均明显高于内科和儿科（P〈0.05）.结论：临床微生物以及细菌耐药性检验有助于院内抗菌药物规范使用,为临床合理用药提供指导.

Objective： The present study aims to investigate the significance of clinical microbiology and bacterial drug resistance test. Methods： 824 strains of bacteria isolated from our hospital from January to December in 2016 were analyzed. Identification and drug sensitivity tests were performed by automatic bacterial identification and drug susceptibility analyzer. Results： Gram positive bacteria and gram negative bacteria accounted for 38.71% and 56.80% respectively in the pathogenic bacteria of the 824 strains; Staphylococcus aureus, Streptococcus pneumoniae and enterococcus were the main gram positive bacterian. Escherichia coli, Pseudomonas aeruginosa and Klebsiella were the main gram negative bacteria; The resistance rates of Staphylococcus aureus to erythromycin and penicillin G were〉80%. The resistance rates of Streptococcus pneumoniae to erythromycin and tetracycline were〉80%. The resistance rate ofEscherichia coli to ampicillin and piperacillin was 80%, and, the drug resistance rate ofPseudomonas aeruginosa to most antimicrobial agents was generally low; 128 st,ains multiple drug resistant strains were detected from 824 strains of pathogenic bacteria, accounting for 15.53%. The multiple drug resistant bacteria proportion oflCU and surgical ward were 20.25% and 18.85% respectively, which were significantly higher than those from internal medicine and pediatrics （P〈0.05） . Conclusion： Clinical microbiology and bacterial drug resistance test could be useful to standardize the use of antibiotics in hospital and provide guidance for clinical rational drug use.