河南濮阳地区近5年临床分离常见病原菌的分布及耐药性分析  

Distribution and resistance analysis of clinical common pathogenic bacteria in recent 5 years

作　　者：李世杰[1] 李自平[1] 刘大宁[1] 马青素[1] 

机构地区：[1]河南省濮阳市人民医院,濮阳457000

出　　处：《中国抗生素杂志》2005年第2期94-96,99,共4页Chinese Journal of Antibiotics

摘　　要：目的分析河南濮阳地区近5年临床分离常见病原菌的分布及耐药情况,为临床医师了解临床常见病原菌的分布及合理应用抗菌药物提供依据。方法用WHONTE5软件对濮阳市人民医院1998年8月至2003年8月5年间临床常见病原菌对常用抗菌药物的耐药情况进行统计分析。药敏采用纸片扩散法。结果我院5年分离临床常见菌株2941例,13种左右,依次分别为金黄色葡萄球菌、凝固酶阴性葡萄球菌、溶血性链球菌、肠球菌属、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、阴沟肠杆菌、奇异变形菌、不动杆菌属、柠檬酸杆菌属、嗜麦芽寡养假单胞菌、洋葱伯克霍尔德菌等。其中革兰阳性菌1468例,占49.9%;革兰阴性菌1473例,占50.1%。革兰阳性菌中以金黄色葡萄球菌和凝固酶阴性葡萄球菌为主,分别占32.5%和10.1%;其中MRSA和MRCNS分别占34.4%和36.1%,未检出耐万古霉素的葡萄球菌。革兰阴性菌中以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、阴沟肠杆菌为主,分别占23.6%、10.1%、3.6%和3.6%。对革兰阳性菌耐药率较高的药物有青霉素(60%～96%)、红霉素(76%～96%)、氯霉素(55%～64%)、头孢曲松(44%～77%);耐药率较高的革兰阳性菌除MRSA、MRCNS外,有肠球菌、革兰阳性菌等。对革兰阴性菌耐药率较高的药物有氨苄西林(60%～98%)、哌拉西林(50%～76%,其中?Objective To investigate the distribution and resistance of clinical common pathogenic ~bacteria and provide the basis for rational use of antibacterials in clinic. Methods Drug sensitivity was performed with Kirby-Bauer agar diffusion method. WHONET 5 software was used in this survey from August 1998 to August 2003. Results 2,941 strains (13 species) were isolated including Staphylococcus aureus, ~coagulase -negative Staphylococcus, Streptococcus calcoaceticus, Enterococcus spp., Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter cloacae, Proteus mirabilis, Acinetobacter, Citrobacter, Stenotrophomonas maltophilia and Burkholderia cepacia. 1,468 strains of Gram-positive bacteria (49.9%) are mainly Staphylococcus aureus (32.5%) and coagulase-negative Staphylococcus (10.1%), in which MRSA and MRCNS are 34.4% and 36.1% repectively and no vancomycin-resistant bacteria are detected. 1,473 strains of Gram-negative bacteria (50.1%) are mainly Escherichia coli (23.6%), Pseudomonas aeruginosa (10.1%), Klebsiella pneumoniae (3.6%) and Enterobacter cloacae (3.6%). The Gram-positive bacteria are highly ~resistant to penicillin with ~resistance rate of 60%～96%, erythromycin (76%～96%), chloramphenicol (55%～64%) and ceftriaxone (44%～77%). Enterobacter and Gram-positive bacilli is highly drug-resistant as well as MRSA and MRCNS. The Gram-negative bacteria are highly resistant to ampicillin with resistance rate of 60%～98%, piperacillin (50%～76%, 15.4% for Proteus mirabilis), cefotaxime (53%～72%, 18.2% for ~Escherichia coli, 10.0% for Proteus mirabilis), ceftriaxone (45%～70%, 23.3% for Escherichia coli, 10.5% for Proteus mirabilis), amoxicillin/ sulbactam (41%～98%, 20% for Proteus mirabilis) and ciprofloxacin (36%～66%, 12.5% for Stenotrophomonas maltophilia). Among Gram-negative bacteria, Acinetobacter and Stenotrophomonas maltophilia are highly drug-resistant. Conclusion Resistant rates of clinical isolates are ~increasing due to irrational use of antibiotics. The resistance rates of

关 键 词：病原菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]