临床分离菌的菌群分布和耐药性变迁

Flora Distribution and Drug Resistance Dynamics of Clinical Isolated Bacteria

目的 了解本地区临床感染细菌的菌群分布和耐药性变迁情况。方法 对我院近 3年来血液、尿液和口痰标本中分离的 2 981株感染菌作回顾性分析 ,并与我院 1993～ 1995年的临床资料作比较。结果 革兰阴性杆菌比例显著升高 ,条件致病菌检出机会显著增多 ,药敏结果普遍显示耐药率有不同程度升高趋势 ,耐甲氧西林葡萄球菌 (MRS)高达 83.1% (其中 MRSA78.0 %、MRCNS86 .0 % ) ;金黄色葡萄球菌和大肠埃希菌对萘啶酸和诺氟沙星的耐药升至 5 0 %以上 ,甲型副伤寒沙门菌则高达 96 %～ 97% ,对氨苄西林、头孢唑林也都有明显升高 (P <0 .0 1) ;革兰阴性杆菌对三代头孢菌素的耐药在 17.4 %～ 5 5 .5 %之间。结论 临床抗生素使用中的耐药性问题十分严峻 ,应定期监测区域内细菌的耐药变化 ,指导临床合理用药。

OBJECTIVE To study the flora distribution and drug resistance dymamics of clinical isolated bacteria in Yuxi city. METHODS A retrospective analysis was made on a total of 2 981 strains of pathogens separated from blood, urine and phlegm samples in the past 3 years compared with the clinical data of our hospital from 1993 to 1995. RESULTS The proportion of Gram negative bacilli rose obviously, so did the opportunistic pathogen′s detected rate. Most drug sensitive tests showed the drug fast rate turned to be high. Meticillin resistant staphylococcus (MRS) was 83.1% (including MRSA 78.0%, MRCNS 86.0%); Staphylococcus aureus and Escherichia coli resistant to nalidixic acid and norfloxacin were above 50%, while Salmonella paratyphi A was 96 97%, whose drug resistance to ampicillin and cefazolin had an obvious rise also(P<0.01); Gram negative bacilli resistant to cephalosporins were between 17.4% to 55.5%. CONCLUSIONS The situation of clinical antibiotic resistance is quite serious, the bacteria′s drug resistance dynamics in our responsible region should examine constantly, so to guide doctors using drugs reasonably.