2007-2009年临床病原菌分布及耐药趋势分析  

Clinical distribution and drug resistant trends of pathogens isolated during 2007-2009

作　　者：张立平[1] 邓丽[1] 郑丽华[2] 朴文花[1] 

机构地区：[1]宁夏回族自治区人民医院检验科,宁夏银川750021 [2]宁夏回族自治区人民医院院感科,宁夏银川750021

出　　处：《中华医院感染学杂志》2011年第6期1220-1223,共4页Chinese Journal of Nosocomiology

基　　金：宁夏自然科学基金项目(NZ10176)

摘　　要：目的分析2007-2009年医院临床分离病原菌的种类、分布及耐药趋势,为临床了解病原菌流行状况、合理使用抗菌药物、预防和控制医院感染发生提供依据。方法采用VITEK-32微生物鉴定药敏系统对分离病原菌进行鉴定和药敏试验。结果分离2694株病原菌中,革兰阴性菌1775株占65.9%、革兰阳性菌579株占21.5%、真菌340株占12.6%;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呈上升趋势;药敏结果显示,大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、阴沟肠杆菌等常见革兰阴性杆菌对氨苄西林耐药率最高,为87.2%~100.0%;对亚胺培南耐药率最低,为0~23.3%;肠球菌属、葡萄球菌属等革兰阳性球菌对青霉素耐药率较高,为54.7%~100.0%;对万古霉素耐药率最低,为0~16.7%。结论医院临床感染的病原菌以革兰阴性杆菌为主,常用抗菌药物的细菌耐药率有逐年增加的趋势,加强病原菌的检测和耐药性监测,合理使用抗菌药物,对控制细菌耐药性的发生和发展至关重要。OBJECTIVE To analyze the types,distributions and drug resistant trends of clinical isolates of pathogens isolated from 2007 to 2009,to provide evidence for clinical understanding of the prevalence of pathogens,the rational use of antibiotics,prevention and control of hospital infection.METHODS Pathogens were identified using Vitek-32 and drug susceptibility testing was performed.RESULTS Of 2694 isolated pathogens,1775（65.9%） were Gram-negative bacilli,579（21.5%） were Gram-positive cocci and 340（12.6%） were fungi.Dynamic analysis showed that the bacterial distribution in recent years,the proportion of Gram-positive cocci infections decreased,while the Gram-negative bacilli infections rose.Susceptibility tests results showed that resistant rates of E.coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Enterobacter cloacae common Gram-negative bacteria to ampicillin were the highest,reaching 87.2%~100%;that to imipenem was the lowest,reached 0~23.3%.The resistant rate of Staphylococcus aureus and other Gram-positive bacteria to penicillin was higer（54.7%~100.0%） and to vancomycin was the lowest（0~16.7%）.CONCLUSION The most common pathogens causing infections are Gram-negative bacilli.The bacteria resistant rates to common antibiotics are gradually increased.To control the occurrence of bacterial resistance and the rational use of antibiotics,It is essential to enhance the detection of pathogens and drug resistance surveillance and reasonably use antibiotics,because of which are important for controlling the occurrence and development of the bacterial resistance.

关 键 词：病原菌 耐药性 医院感染 

分 类 号：R378[医药卫生—病原生物学]