无菌体液与非无菌体液细菌耐药监测对比分析

The comparison of bacterial resistance surveillance between sterile body fluid and non-sterile body fluid

目的探讨该院2014年无菌体液与非无菌体液来源细菌的菌种分布及耐药性的差异。方法采用回顾性分析方法,应用BD Phoenix^(TM)100全自动细菌鉴定药敏系统进行细菌鉴定与药敏检测,应用Whonet5.6软件和SPSS19.0统计软件对细菌耐药率进行统计分析。结果无菌体液分离率最高的细菌为大肠埃希菌(43%),非无菌体液分离率最高的细菌为铜绿假单胞菌(21%)。无菌体液来源的大肠埃希菌对氨苄西林、氨曲南、环丙沙星、氯霉素等11种抗菌药物耐药率低于非无菌体液来源的菌株,无菌体液来源的金黄色葡萄球菌对阿米卡星、阿莫西林/克拉维酸、环丙沙星等6种抗菌药物耐药率低于非无菌体液来源的菌株,无菌体液来源的铜绿假单胞菌对氨曲南耐药率低于非无菌体液来源的菌株,无菌体液来源的肺炎克雷伯菌对氨苄西林/舒巴坦、复方新诺明、氯霉素等6种抗菌药物耐药率低于非无菌体液来源的菌株,差异均有统计学意义(P<0.05)。结论无菌体液与非无菌体液来源细菌的菌种分布及耐药性存在差异,加强无菌体液细菌耐药性监测尤为重要。

Objective To compare the distribution and drug resistance of isolates between sterile body fluid and non-sterile body fluid in the hospital in 2014.Methods By adopting the retrospective analysis method,we used BD phoenixTM100 to conduct bacteria identification and drug susceptibility testing,the Whonet5.6software and SPSS19.0software to statistically analysize the drug resistance of the bacteria.Results E.coli ranked the top in sterile body fluid isolates（43%）while the highest rate in non-sterile body fluid was P.aeruginosa.E.coli（21%）.Isolates from sterile body fluid had lower drug resistance rate to 11 kinds of antibacterials such as ampicillin,chloramphenicol,ciprofloxacin and aztreonam than the strains isolated from non-sterile body fluid（P<0.05）.S.aureus,isolated from sterile body fluid,had lower drug resistance rate to 6kinds of antibacterials such as amikacin,amoxicillin/clavulanicacid,ciprofloxacin than the strains isolated from non-sterile body fluid.P.aeruginosa,isolated from sterile body fluid,had lower drug resistance rate to aztreonam than the srains isolated from non-sterile body fluid.K.pneumoniae,isolated from sterile body fluid,had lower drug resistance rate to 6kinds of antibacterials such as ampicillin/sulbactam,sulfamethoxazole,chloramphenicol than the strains isolated from non-sterile body fluid（P<0.05）.Conclusion There is significant difference between sterile body fluid and sterile body fluid in strain distribution and drug resistance,so it is vital to enhance the bacterial resistance surveillance of sterile body fluid.