377株院内感染的病原体及耐药性分析  

Antibiotic resistance and distribution of 377 cases of pathogens that cause nosocomial infection

作　　者：张豫明[1] 曾方银[2] 孙德华[2] 

机构地区：[1]南方医科大学中西医结合医院检验科,广州510315 [2]南方医科大学南方医院检验科,广州510315

出　　处：《国际检验医学杂志》2011年第10期1059-1060,1062,共3页International Journal of Laboratory Medicine

基　　金：广东省自然科学基金资助项目(9451051501003704)

摘　　要：目的 了解院内感染的病原学特点及其耐药情况,为临床治疗提供参考.方法 对该校2所附属医院2008年7～12月住院患者发生医院感染的病原体分布及耐药情况进行回顾性分析.结果 共检出病原菌377株,其中革兰阴性（G-）菌313株,占83.02%;革兰阳性（G＋）菌62株,占16.45%;真菌2株,占0.53%.G-菌以铜绿假单胞菌（25.20%）、肺炎克雷伯菌（22.55%）、鲍曼不动杆菌（16.18%）和大肠埃希菌（13.00%）等为主;肺炎克雷伯菌和大肠埃希菌产ESBLs最多,分别是53.73%和40.54%.G＋菌中,耐甲氧西林葡萄球菌占葡萄球菌的54.29%;G-菌中,铜绿假单胞菌和鲍曼不动杆菌对各种抗菌剂均表现出高耐药性,未发现肺炎克雷伯菌和大肠埃希菌的亚胺培南耐药菌株;葡萄球菌对利奈唑烷、复方新诺明、呋喃坦啶及万古霉素的敏感性高（0.00%～4.44%）.结论 院内感染的病原菌中,ESBLs菌株和耐甲氧西林葡萄球菌检出率高,耐药性严重且为多重耐药,应引起临床重视.Objective To investgate the features and drug resistance of pathogens that cause nosocomial infection to establish reference for clinical therapy. Methods The distribution and drug resistance of pathogens that cause nosoemial infection during July to December 2008 in the two hospitals were retrospectively analyzed. Results 377 strains of pathogenic bacteria were detected,among which 313 （83.02 % ） strains were gram-negative, 62 （16.45 %） were gram-positive and 2 （0.530% ） were fungi. The detection rates of mainly gram-negative pathogens,ranged from high to low were 25.20 % of pseudomonas aeruginosa,22.55 % of klebsiella pneumoniae, 16.18% of acinetobacter baumanii, and 13.00% of escherichia coli. Pathogens, producing ESBLs, mainly were escherichia coli （40.54%） and klebsiella pneumoniae （53.73%）. Among pathogens of gram-positive cocci,the proportion of methicillinresistant ylococcus was 54.29 %. Among gram-negative pathogens, pseudomonas aeruginosa and aeinetobaeter baumanii were highly resistant to various antibiotic,but klebsiella pneumoniae and escherichia coli strains were all sensitive to imipenem. The drug resistance rate of staphylococcus to linezolid, cotrimoxazole, furadantin and vancomycin were between 0.00% to 4.44%. Conclusion A- mong the all identified pathogens that cause nosocomial infection,the detection rates of ESBLs positive strains and Methieillin-resistant Staphylococcus were relative high. Serious drug and multi-drug resistance should be pay close attention.

关 键 词：交叉感染 病原 抗药性 

分 类 号：R446.5[医药卫生—诊断学]