儿童常见病原菌的分布及其耐药性监测

A surveillance of flora distribution of clinical bacteria and their drug resistance

目的?调查我院临床分离病原菌菌群分布并进行耐药性监测,为临床合理使用抗生素提供依据。方法:我院 2001 年 1 月至2002 年 12 月临床分离病原菌 4328 株,按 NCCLS( 2000)标准判断结果, 2853 株 G 杆菌和 G 球菌采用 M icroScan鄄W alkAway40 全 - +自动微生物分析仪鉴定及药敏, 1478 株苛氧菌采用 Kirby鄄Bauer法进行纸片药敏实验。结果: 2583 株 G 杆菌和 G 球菌中,杆菌占 - +74.6% ,其中以大肠埃希氏、肺炎克雷伯菌为主;球菌占 25.4% ,其中以金黄色葡萄球菌和表皮葡萄球菌为主;呼吸道苛氧菌以肺炎链球菌和副流感嗜血杆菌为主,分别是 31.4% 、 35.2% 。药敏结果显示:大肠埃希氏、肺炎克雷伯菌除对亚胺培南、哌拉西林鄄 他唑巴坦、头孢西丁、阿米卡星敏感,而对其它抗生素的耐药率均 > 50% 。铜绿假单孢菌、阴沟杆菌对环丙沙星、亚胺培南敏感,而对其它药物均有不同程度耐药。嗜麦芽黄单孢菌呈高度多重耐药性。金黄色葡萄球菌对氨苄西林、青霉素、红霉素耐药率分别高达 97% 、97% 、 ,其它 G+ 球菌对大多数抗生素的耐药率为 60% ￣90% ;

Objective: To investigate the distribution and the antibiotic resistance of bacteria separated from clinical samples and instruct reasonable clinical drug application. Methods: 4328 clinical isolates were collected from our hospital from Jan 2001 to Dec 2002. According to NCCLS (2000), 2853 gram-negetive bacilli and gram-positive cocci were identified and their antibiotic susceptibility were tested by Microscan-wolk/40, and the 1478 fastidious bacteria were tested with K-B method. Results: In 2583 clinical isolates, gram-negetive bacilli accouted for 74.6% and gram-positive cocci were 25.4 %. E. coli and K. pneumoniae were the main gram-negetive bacilli, S. aureus and S. epidermidis were the main gram-positive cocci. The main fastidious bacteria included mainly S. pneumoniae and H. parainfluenzae, which occupied 31.4% and 35.2% respectivity. Drug sensitive tests showed that E. coli and K. pneumoniae were resistant to most antibiotics, with a resistant rate more than 50%, but sensitive only to imipenem, piperacillin, cefoxition, amikacin. P. aerugiinosa and E. cloacae showed variant resistences to most antibiotics except ciprofloxacin and imipenem. S. meltophilia showed obviously multi-drug resistence. S. aureus' resistant rate to ampillin, penicillin, erythromycin were 97%, 97% and 67%, respectivity. Other gram-positive cocci resistant rate to most antibiotics were 60% to 90/%. S. pneumoniae resistant rate were the highest in fastidious bacteria, which resistant to erythromycin, oxacillin, trimeth/sulfa were 81.1%, 76.9% and 76.9% respectively. Conclusions: The situation of clinical antibiotic resistence is quite serious in our region, then the bacteria's drug resistence dynamics should be examined constantly, so to guide clinical drug application accordingly and then reasonably.