我院2004～2007年度临床病原菌分布和耐药趋势动态分析  

The dynamic analysis of the distribution and antibiotic resistance of clinical pathogenic microorganism isolated from 2004 to 2007

作　　者：夏云[1] 曹何[1] 罗疏薇[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》2009年第8期1093-1097,共5页Journal of Chongqing Medical University

摘　　要：目的:了解近几年我院临床分离的病原菌种类和耐药性趋势。方法:对2004～2007年临床送检标本按常规进行病原菌分离,采用Vitek2和ATBExpress系统对病原菌进行鉴定,并测定其对相应抗生素的耐药性。结果:共分离10700株菌,以革兰阴性杆菌为主。细菌分布动态分析表明近年来革兰阳性球菌感染比例呈下降趋势,而革兰阴性杆菌感染中以铜绿假单胞菌上升最明显。药敏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。耐药性动态观察表明,铜绿假单胞菌和鲍曼不动杆菌对碳青霉烯类抗生素的耐药性上升明显。结论:我院临床感染的病原微生物种类以革兰阴性杆菌为主,其中以铜绿假单胞菌上升趋势较为明显。在耐药性方面也已发生了较为明显的变化,特别是对碳青霉烯类抗生素耐药的铜绿假单胞菌和鲍曼不动杆菌比例显著上升,提示该类细菌在我院特别是ICU病房可能存在流行。Objective：To investigate the profile of the distribution and antibiotic resistances of clinic pathogenic microorganism isolated from 2004 to 2007.Methods：The microorganisms were isolated from clinical samples according to the guides of standard operation protoco1.Identification and antibiotic sensitivity tests were done by Vitek2 and ATB Express system.Results：A total of 10 700 bacteria were isolated,most of which are gram-negative rods.The dynamic analysis of the bacteria distribution showed that infections caused by gram positive coccus exhibited a decreasing tendency,while the infections caused by the P aeruginosa were increasing significantly.The dynamic analysis of antibiotic resistance showed that E coli,K pneumoniae,A baumanii,P aeruginosa were totally sensitive to Imipenem,Meropenem,Amikacin,Piperacillin-tazobactam.Vancomycin,Teicoplanin,Nitrofurantoin exhibited strong anti-bacterial activities against Staphylococcus spp and Enterococcus spp.The dynamic analysis results indicated that the resistance rates to carbapenem in P aeruginosa and A baumanii were increasing sharply.Conclusion：The major clinical pathogenic microorganisms in our hospital were Gram negative rods.Isolating rate of P aeruginosa showed an obviously increasing tendency.The antibiogram profiles of microorganisms have changed obviously,especially the ratios of P aeruginosa and A baumanii that are resistant to carbapenem rose significantly,which suggested the two kinds of organisms were in prevalence in our hospital especially in ICU words.

关 键 词：抗药性 微生物 抗生素敏感试验 

分 类 号：R446.5[医药卫生—诊断学]