老年病科患者临床感染细菌耐药性分析  

Antibiotic resistance of common pathogenic bacteria causing clinical Infection in geriatric department

作　　者：徐卫刚[1] 沈瑜[1] 浦裕美[1] 徐伟民[1] 

机构地区：[1]上海市皮肤病性病医院内科,上海200443

出　　处：《中华医院感染学杂志》2011年第1期175-177,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨老年病科临床感染常见病原菌分布及耐药状况。方法对2009年老年病科所有细菌送检标本进行专项分析,药敏采用K-B纸片法,WHONET 5.4软件进行统计。结果老年病科患者细菌学检出率低,为51.5%;排在前3位的革兰阳性球菌分别是金黄色葡萄球菌(10.0%)、粪肠球菌(1.9%)、屎肠球菌(1.6%)均对万古霉素100.0%敏感,排在前3位的革兰阴性菌主要为大肠埃希菌(28.8%)、肺炎克雷伯菌(16.6%)、铜绿假单胞菌(16.4%)其对亚胺培南敏感率最高,头孢哌酮/舒巴坦是仅次于碳青霉烯类外最敏感的抗菌药物;产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌检出率分别为48.0%和18.3%,耐甲氧西林金黄色葡萄球菌检出率为62.8%;添加酶抑制剂的抗菌药物对大肠埃希菌、肺炎克雷伯菌的药物敏感性极显著高于未添加酶抑制剂者。结论老年临床感染病原菌耐药性高,头孢哌酮/舒巴坦和万古霉素是其较为理想的选择。OBJECTIVE To analysis the distribution and antibiotic resistance of commom pathogenic bacteria in the patients with Clinical infection in Geriatrics Dept. METHODS An investigation of all bacteriology specimens was carried out in 2009. Microbial sensitivity tests were performed by K-B disk diffusion method and the data was analyzed by WHONETS. 4. RESULTS The bacteriology detection rate of patients in Geriatrics Dept was 51.5 %. The top three clinical isolates of Gram-positive cocci were Staphylococcus aureus, Enterococcus faecalis and E. faeciurn, which were 100.0% sensitive to vancomycin. The top 3 Enterobacteriaceae bacteria were E. coli, Klebsiella pneurnoniae and P. aeruginosa. Enterobacteriaceae was most sensitive to imipenem. Cefoperazone/ sulbactam, which was inferior to carbapenem, was the most sensitive antibiotic. The detection rates of ESBLs- producing E. col i and K. pneumoniae were 48% and 18. 3%, respectively. The detection rate of MRSA was 62.8%. The drug sensitivity of the antibiotics which were added enzyme inhibitors to E. coli and K. pneumoniae was significantly higher than that without adding. CONCLUSIONS The antibiotic resistance of the pathogenic bacteria is very high in geriatrics department. Cefoperazone/sulbactam and vancomycin are the ideal antibiotics.

关 键 词：老年病科 耐药性 病原菌 超广谱Β-内酰胺酶 

分 类 号：R378[医药卫生—病原生物学]