医院感染常见革兰阴性细菌分布及耐药性分析  

Bacterial Distribution and Resistance of the Common Infectious Gram-negative Bacilli in Hospital: An Analysis

作　　者：苏丹虹[1] 邬全会[2] 肖庆忠[1] 

机构地区：[1]广州医学院第一附属医院,广东广州510120 [2]广州市东山区人民医院,广东广州510080

出　　处：《中华医院感染学杂志》2004年第1期91-93,共3页Chinese Journal of Nosocomiology

基　　金：广州市科技局重大攻关项目资助(2 0 0 0 - Z- 0 2 7- 0 1- 2 )

摘　　要：目的　了解医院感染常见革兰阴性细菌分布变迁和耐药趋势。方法　对我院 2 0 0 0年 1月～ 2 0 0 2年 12月3年中从医院感染患者标本中分离出的主要致病菌 ,采用美国 BD公司的 Sceptor细菌鉴定仪和法国梅里埃 API生化鉴定试条进行鉴定 ,并按美国临床实验标准委员会 2 0 0 0年判断标准用纸片扩散法进行药物敏感实验。结果　 2 0 0 0年 1月～ 2 0 0 2年 12月 3年中共分离出病原菌 186 4株 ,其中革兰阴性菌为 10 85株 ,占 5 8.2 % ,革兰阳性菌为 779株 ,占 4 1.8% ;革兰阴性细菌中前 5位细菌依次是 :大肠埃希菌 398株占 36 .7% ,铜绿假单胞菌 189株占 17.4 % ,肺炎克雷伯菌 110株占 10 .1% ,奇异变形菌 6 1株占 5 .6 % ,阴沟肠杆菌 37株占 3.4 % ;耐药性分析显示 :革兰阴性杆菌对临床常用抗生素的耐药率最低为亚胺培南 (均值是 :10 .5 % ) ,最高为氨苄西林 (均值为 :83.3% ) ,大部分细菌呈多重耐药。结论　细菌耐药性仍是目前临床上最为严重的问题 ,因此掌握细菌变迁动态 ,不断进行耐药性监测 ,指导临床合理应用抗菌药物是临床微生物实验室的首要目标。OBJECTIVETo determine the tendency of bacterial distribution and drug-resistance of the common Gram-negative bacilli in hospital. METHODSBacteria isolated from patients in our hospital, from Jan 2000 to Dec 2002 were identified by Sceptor (BD Inc, USA) and API identified tests (API Inc, France). Bacterial drug susceptibility test was performed on strains using standard Kirby-Bauer method in accordance with guidelines of NCCLS (2000). RESULTS A total of 1 864 strains of pathogens were isolated in the past three years, among them 779 strains were Gram-positive cocci (41.8%); 1 085 strains Gram-negative bacilli and the most common pathogens of them were Escherichia coli (398 strains, 36.7%), Pseudomonas aeruginosa(189 strains, 17.4%), Klebsiella pneumoniae (110 strains, 10.1%), Proteus mirabilis (61 strains, 5.6%) and Enterobacter cloacae (37 strains, 3.4%). In our surveillance, the highest susceptible to Gram-negrative bacilli was imipenem (89.5%), while the lowest was ampicillin (16.7%). Most of isolates were multi-drug resistant. CONCLUSIONSDrug resistance of clinical isolates is a serious problem in hospital. It has a very important clinical value to inspect the bacterial spectrum and drug resistance of the common Gram-negative bacilli in hospital.

关 键 词：医院感染 细菌分布 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]