2005-2009年临床分离病原菌分布及耐药性变迁  

Distribution and antimicrobial resistance variation of pathogenic bacteria isolated from clinical specimens during 2005-2009

作　　者：黄东标[1] 周茂亮[1] 李嫦珍[1] 陈江平[1] 胡晓燕[1] 黄邦智[1] 

机构地区：[1]浙江省磐安县人民医院,浙江磐安县322300

出　　处：《中华医院感染学杂志》2011年第6期1216-1219,共4页Chinese Journal of Nosocomiology

摘　　要：目的了解医院2005-2009年常见临床分离病原菌的构成比及耐药性的变迁,为临床合理使用抗菌药物提供依据。方法采用黑马Bact-IST微生物分析系统及配套试剂进行菌种鉴定和药敏试验,使用WHONET5.4软件进行回顾性统计分析。结果共检出病原菌3943株,包括2499株革兰阴性菌(63.4%)和1444株革兰阳性菌(36.6%),分离前5位的病原菌是大肠埃希菌(14.2%),金黄色葡萄球菌(12.4%)、表皮葡萄球菌(11.4%)、肺炎克雷伯菌(10.2%)和铜绿假单胞菌(8.1%),耐甲氧西林金黄色葡萄球菌(MRSA)检出26.4%,未发现对万古霉素耐药的葡萄球菌属或肠球菌属;肺炎克雷伯菌和金黄色葡萄球菌检出率有增加趋势,尤以2008-2009年较为显著。结论病原菌以革兰阴性菌为主,病原菌的耐药情况日趋严重,加强对临床感染病原菌的耐药监测,对指导合理使用抗菌药物具有重要意义。OBJECTIVE To investigate the pathogenic distribution and antimicrobial resistance of bacteria isolated from clinical specimens,which were collected during the period of 2005-2009,and provide rational information to choose antibiotics reasonably.METHODS The identification of isolated bacteria was performed by the Bact-IST system,and the antimicrobial resistance was examined by MIC method.A retrospective analysis was made to the bacteria culture results with WHONET 5.4 software.RESULTS Totally 3943 strains of pathogenic bacteria were isolated,including 2499 strains of Gram-negative bacteria（64.3%） and 1444 strains of gram-positive bacteria（34.6%）.The first five common strains were Escherichia coli（14.2%）,Staphylococcus aureus（12.4%）,Coagulase-negative Staphylococci（11.4%）,Klebsiella（10.2%）,and Pseudomonas aeruginosa（8.1%）.MRSA prevalence was 26.4% and showed no signs of rise.No vancomycin-resistant S.aureus or Enterococcus was detected.The infection rates of S.aureus and Klebsiella showed a trend of increase,which is significant in 2008-2009.CONCLUSION Gram-negative bacteria are still the most common pathogens and the severity of antimicrobial resistance is soaring.More attention should be paid to the detection and surveillance of antimicrobial resistance to ensure the rational use of antibiotics.

关 键 词：病原菌 抗菌药物 耐药性 变迁 

分 类 号：R378[医药卫生—病原生物学]