临床分离的4379株病原菌的分布特征及药敏结果分析  

Analysis of Distribution and Drug Resistance Spectrum of 4379 Clinical Bacteria and Candida Isolates

作　　者：芮勇宇[1] 王前[1] 裘宇容[1] 

机构地区：[1]南方医科大学南方医院检验科,广州510515

出　　处：《热带医学杂志》2009年第10期1154-1157,1187,共5页Journal of Tropical Medicine

摘　　要：目的了解本院2008年临床分离的病原菌的分布特征及药敏结果,为合理使用抗菌药物提供依据。方法大多数细菌鉴定和药敏试验利用BD Phoenix仪,少数利用手工鉴定和K-B法药敏试验。念珠菌利用显色平板分离和鉴定,K-B法进行药敏试验。结果4379株细菌念珠菌中最常见的为大肠埃希菌(10.2%)、铜绿假单胞菌(9.4%)、金黄色葡萄球菌(7.7%)、鲍曼不动杆菌(7.7%)、白色念珠菌(7.0%)和肺炎克雷伯菌(6.2%)。大肠埃希菌和肺炎克雷伯菌产ESBLs比例分别为47.8%和41.3%。金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌和腐生葡萄球菌甲氧西林耐药率分别为58.1%、82.8%、83.6%和73.1%。G-杆菌中耐药率较低的为头孢哌酮/舒巴坦、亚胺培南、哌拉西林-他唑巴坦和阿米卡星。G+球菌,万古霉素和替考拉宁的敏感率均为100.0%,其他抗菌药物耐药率较低的为氯霉素。念珠菌对两性霉素B和制霉菌素的耐药率均低于2.0%。结论本院临床分离大肠埃希菌和肺炎克雷伯菌产ESBLs水平、非发酵G-杆菌碳青霉烯类耐药率和葡萄球菌甲氧西林耐药率居高不下,应加强抗菌药物的合理使用,以降低耐药率。Objective To investigate distribution and drug resistance spectrum of clinical bacteria and candida isolates from a hospital in year 2008,and provide information for using suitable antibiotics.Methods Bacteria isolates were identified with BD Phoenix and K-B method.Candida isolates were identified by color display plate and by K-B method.Results The common bacteria strains of the isolates were Escherichia coli（10.2%）,Pseudomonas aeruginosa（9.4%）,Staphylococcus aureu（7.7%）,Acinetobacter baumannii（7.7%）, Candida albicans （7.0%）,Klebsiella pneumoniae （6.2%）. The incidences of E.coli and K.pneumoniae isolates producing extended spectrum beta-lactamase（ESBLs） were 47.8% and 41.3%, respectively. The methecillin resistant rates of S.aureu,S.epidermidis, S.haemolyticus and S.saprophyticus were 58.1%, 82.8%, 83.6%,and 73.1%, respectively. In gram negative bacillus, lower resistant rates of antibiotics were Cefoperazone/Sulbactam, Imipenem, Piperacillin/Tazobactam, and Amikacin.In gram positive coccus,susceptible rates of Vancomycin and Teicoplanin were 100.0% ,lower resistant rate of antibiotic was Chloramphenicol. In Candida isolates, resistant rates of Amphotericin B and Nystain were below 2.0%. Conclusion The production ratios of ESBLs of E.coli and K.pneumoniae, carbopenems resistance of non-ferment gram negative bacillus and methicillin resistance of staphylococci were high. It is important to enforce the rational use of antimicrobial agents to reduce resistant rates of bacteria.

关 键 词：细菌 耐药 超广谱Β-内酰胺酶 甲氧西林耐药性 

分 类 号：R446.5[医药卫生—诊断学]