我院2015年痰培养细菌菌谱和耐药性分析

Bacteria Bacterium Spectrum of Sputum Culture in Our Hospital in 2015 and Drug Resistance Analysis

目的了解我院2015年门、急诊及住院病人合格痰标本的细菌菌种及耐药情况,为临床合理用药提供依据。方法统计和整理2015年我院检验科合格痰标本细菌的培养结果,并对其药敏试验进行回顾性分析和总结。结果 2015年我院595例痰培养标准中,革兰阴性杆菌565株,占94.96%,以铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌为主;革兰阳性球菌30株,占5.04%,以金黄色葡萄球菌为主。药敏结果显示铜绿假单胞菌对阿米卡星和妥布霉素较敏感,达87.3%以上;鲍曼不动杆菌对亚胺培南与美罗培南的敏感率分别为30.25%和29.6%,对复方新诺明敏感率为33.40%;肺炎克雷伯菌对亚安培南、美罗培南的敏感率最高,达92%以上,对厄他培南、阿米卡星的敏感性亦较高;金黄色葡萄球菌对利奈唑胺、复方新诺明100%敏感,对达托霉素、奎奴普丁/达福普汀和万古霉素敏感率也高,达92%以上。结论医院痰培养细菌以革兰阴性菌为主,耐药现象较为严重,尤其是鲍曼不动杆菌耐药情况严重,应采取有效干预措施加强监管,合理使用抗菌药物,减缓细菌耐药。

Objective to understand bacteria strains of patient's qualified sputum specimens of outpatient, emergency and inpatient and drug resistance situation in our hospital in 2015, to provide basis for clinical reasonable use of medicine. Method carry on statistics and collating of culture result of qualified sputum specimens in clinical laboratory of our hospital in 2015, and review, analyze and summarize drug sensitive test. Result among 595 cases of sputum culture standard in our hospital in 2015, there were 565 strains of gram-negative bacilli, accounting for 94.96%, mainly pseudomonas aeruginosa, acinetobacter baumannii, klebsiella pneumoniae; 30 strains of gram positive coccus, accounting for 5.04%, mainly staphylococcus aureus. Drug sensitivity result showed pseudomonas aeruginosa was sensitive to amikacin and tobramycin, which was more than 87.3%; sensitivity rate of acinetobacter baumannii to imipenem and meropenem was 30.25% and 29.6% respectively, that was 33.40% to co-trimoxazole; sensitive rate of klebsiella pneumoniae was the highest to imipenem and meropenem, which was more than 92%, that was high to ertapenem and amikacin also; staphylococcus aureus was 100% sensitive to linezolid and co-trimoxazole, and its sensitive rate was high to daptomycin, quinupristin/dalfopristin syncercid and vancomycin, reaching more than 92%., and compound new Ming, 100% for toxin, Kui Nu putin/dafoe leptin and vancomycin sensitive rate is, above 92%. Conclusion sputum culture bacteria in hospital mainly includes gram-negative bacilli with serious drug resistance, especially acinetobacter baumannii, effective intervention measures should be taken to strengthen supervision and rational use of antimicrobial agents, to reduce bacterial drug resistance.