2008～2012年我院常见细菌的分离及耐药性分析  

Separation and analysis of the common bacterial resistance in our hospital from 2008to 2012

作　　者：周静[1] 尹志国[1] 黄炜[1] 詹先萍[1] 寇安[1] 江自成[1] 

机构地区：[1]安康市中心医院,安康725000

出　　处：《西北药学杂志》2013年第5期527-530,共4页Northwest Pharmaceutical Journal

摘　　要：目的了解我院近年来常见细菌的分离率及耐药情况,为医院抗菌药物的遴选和临床合理应用提供依据。方法收集我院2008年1月~2012年6月临床送检标本,按照全国临床检验操作规程（第3版）培养、分离、鉴定,采用K-B纸片扩散法进行药敏试验。将分离出的病原菌及其药敏资料进行统计分析。结果 4年多共分离到病原菌7 180株,其中G＋菌1 799株,占25.1%;G-菌5 381株,占74.9%。排名前5位的细菌依次为大肠埃希菌、肺炎克雷伯杆菌、铜绿假单胞菌、阴沟杆菌、鲍曼不动杆菌。鲍曼不动杆菌、金黄色葡萄球菌、铜绿假单胞菌的分离率逐年上升,特别是鲍曼不动杆菌上升的幅度比较大。美洛西林、丁胺卡那霉素、万古霉素、亚胺培南对目标细菌处于较低的耐药率。葡萄球菌属细菌对青霉素耐药率均在93%以上,对红霉素的耐药率在70%以上。未发现耐万古霉素的葡萄球菌。肺炎链球菌对青霉素的耐药率为43.1%,对红霉素、复方新诺明、克林霉素的耐药率在90%左右;对左氧氟沙星、氯霉素较敏感。肠杆菌科细菌对美洛西林、亚胺培南、丁胺卡那霉素较为敏感。铜绿假单胞菌耐药率最低的是多黏菌素B和美洛西林。鲍曼不动杆菌对米诺环素耐药率最低。结论我院常见细菌耐药情况与全国其他地区的水平相近,但美洛西林、氟喹诺酮类等对目标细菌的耐药率低于文献报道,临床应重视细菌学检查,根据细菌耐药情况合理使用抗菌药物。Objective To understand the situation of drug resistance rate of our hospital in recent years,and to provide the basis for antimicrobial drugs selection and clinical rational application.Methods The clinical specimens of our hospital during January 2008 to June 2012were separated and identified according to the clinical inspection procedures（the third edition）,then the antimicrobial susceptibility were tested by Kirby-Bauer plate dilution method.The collected resistance data were analyzed.Results A total of 7 180strains of pathogenic bacteria were separated in our hospital during nearly four and a half years,among which the Gram positives and negatives were 1 799and 5 381,accounted for 25.1% and 74.9%,respectively.The top five isolates in the bacteria were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Enterobacter cloacae,and Acinetobacter baumannii.The separation rate of A.baumanii,Staphylococcus aureus,and Pseudomonas aeruginosa were raising year by year,especially A.baumanii.Mezlocillin,amikacin,vancomycin,and imipenem were at a low resistance rate to target bacteria.The resistance rate of Staph bacteria to penicillin and erythromycin were above 93%and 70%,respectively.No vancomycin resistant staphylococcus was found.The resistance rate of Streptococcus pneumoniae to penicillin were 43.1%,and to erythromycin.Compound sulfamethoxazole were about 90%,but to levofloxacin,chloromycetin were sensitive.Enterbacteriaceae bacteria to meziocillin,imipenem and amikacin were sensitive.The drug resistance rate of Pseudomonas aeruginosa to polymyxin B and mezlocillin were the lowest.and A.baumanii resistant to minocycline were the lowest.Conclusion The resistance to antimicrobial agents of common bacteria in our hospital is a serious problem,closing to the request of the nation′s level.But the resistance of mezlocillin,fluoroquinolones to target bacteria were less than other reports in the literature.The clinical doctors should attach importance to the bacteriologic studies,and use the antimicrobial a

关 键 词：抗菌药物 病原菌 分离率 耐药性 

分 类 号：R969.3[医药卫生—药理学]