2005年度临床病原菌分布和耐药性分析  

The distribution and drug resistance analysis of clinic pathogenic microorganism isolated in 2005

作　　者：夏云[1] 罗疏薇[1] 曹何[1] 张晓恒[1] 

机构地区：[1]重庆医科大学附属第一医院检验科,重庆400016

出　　处：《重庆医科大学学报》2006年第5期718-721,共4页Journal of Chongqing Medical University

摘　　要：目的:了解2005年度我院临床分离的病原菌种类和耐药性特点。方法:对临床送检标本按常规进行病原菌分离,采用Vitek-Two和ATB-Express系统对病原菌进行鉴定,采用微量肉汤稀释法测定对相应抗生素的MIC值并根据美国临床实验室标准化研究所的指导原则判定细菌耐药性。结果:共分离2352株菌,以革兰阴性杆菌为主,感染类型以呼吸道感染最为常见。念株菌和肠球菌的分离率与2004年比相明显增高。分离率排名前十位的病原菌分别为大肠埃希菌、铜绿假单胞菌、白色念珠菌、鲍曼不动杆菌、肺炎克雷伯菌、粪肠球菌、热带念珠菌、阴沟肠杆菌、金黄色葡萄球菌、溶血葡萄球菌。药物敏感结果显示大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌等常见革兰阴性杆菌对亚胺培南、美洛培南、阿米卡星、哌拉西林/他唑巴坦等抗生素的耐药率较低。万古霉素、替考拉宁、呋喃妥因对肠球菌和葡萄球菌等革兰阳性球菌具有强大的抗菌活性,白色念珠菌和热带念珠菌对所试抗真菌药物保持较高的敏感率。结论:临床感染的病原微生物种类和耐药性已发生了较为明显的变化,特别是医院感染占相当大的比例,引起感染的病原菌耐药性严重,耐药性监测对临床正确的抗生素治疗具有重要的指导作用。Objective： To investigate the profile of the distribution and drug resistances of clinic pathogenic microorganism isolated in 2005. Methods： The microorganisms were isolated from clinical samples according to the guides of standard operation protocol. Antibiotic sensitivity tests were done by the method of micro broth dilution tests and the values of the MIC were compared by the guides of American Clinical Laboratory Standard Institution. Results：In total 2352 isolated strains, most of them were Gram negative bacilli and mainly caused respiratory tract infection. The isolating rates for Candida spp and Enterococcus spp have increased dramatically compared with the results of 2004. The ten pathogens ranking top isolating rates were Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Acinetobacter baumannii, Klebsiella pneumoniae, Enterocoecus faecalis, Candida tropicalis, Enterobacter cloacae, Staphylococcus aureus, Staphylococcus haemolyticus respectively.The antibiotics exhibiting high activity against common gram-negative bacilli such as Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa were imipenem, meraopenem, amikacin and piperacillin/tazobactam.Vancomycin,teicoplanin and nitrofurantoin remained high activity against Enterocoecus spp and Staphylococcus spp. Candida albicans and Candida tropicalis were susceptible to amphotericin B, fluconazole, and itraconazole. Conclusion： The species of pathogens causing clinical infections and the profiles of their drug resistance have presented obvious variation, especially the pathogens that cause nosocomial infections exhibit high degree of resistance to the antibiotics that conventionally used in clinics. The surveillance of drug resistance is important in the guiding practice of clinical infection control.

关 键 词：抗药性 微生物 抗生素敏感试验 

分 类 号：R915[医药卫生—微生物与生化药学]