1616株临床常见病原菌分布及耐药性分析  

Distribution and drug resistance of 1616 isolates of common pathogenic bacteria

作　　者：刘双[1] 滕清良[1] 刘佳丽[1] 刘运林[2] 

机构地区：[1]泰安市中心医院血液内科,山东泰安271000 [2]泰安市中心医院神经内科,山东泰安271000

出　　处：《中华医院感染学杂志》2013年第21期5293-5295,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金项目(ZR2011HM001)

摘　　要：目的探讨临床常见病原菌分布及耐药性,为临床控制感染选择敏感抗菌药物提供依据。方法用WalkAway 96PLUS自动化微生物鉴定仪进行菌株鉴定,采用微量稀释法和K-B法检测临床分离主要病原菌的耐药率,同时对各种病原菌的分布进行分析。结果 2012年4-6月临床共分离病原菌1616株,分离率前4位病原菌均为革兰阴性杆菌,依次为鲍氏不动杆菌216株占13.3%、肺炎克雷伯菌196株占12.1%、铜绿假单胞菌194株占12.0%、大肠埃希菌177株占11.0%;大肠埃希菌主要从尿液和痰液中检出,检出率分别占45.2%和19.2%;其余病原菌主要从痰液中检出,检出率在73.0%～83.5%;肺炎克雷伯菌和大肠埃希菌对哌拉西林/他唑巴坦、阿米卡星和亚胺培南的耐药率<18.0%,对左氧氟沙星、环丙沙星、阿莫西林/克拉维酸、头孢西丁、头孢唑林和氨苄西林的耐药率在12.4%～100.0%;铜绿假单胞菌和鲍氏不动杆菌对阿米卡星、左氧氟沙星、环丙沙星、头孢吡肟、头孢他啶、庆大霉素、妥布霉素、亚胺培南、头孢噻肟、磺胺甲噁唑/甲氧苄啶、哌拉西林/他唑巴坦耐药率在13.3%～100.0%,且鲍氏不动杆菌的耐药性显著高于铜绿假单胞菌。结论为有效控制病原菌引起的感染,临床上应动态监测常见病原菌的耐药性,根据病原菌的耐药特点合理选用敏感抗菌药物。OBJECTIVE To investigate the distribution and drug resistance of common clinical isolates of pathogenic bacteria so as to choose sensitive antibiotics for the control of infections. METHODS The strain identification was performed with WalkAway 96 PLUS automatic microbiological instrument, then microdilution method and K-B method were used to test the drug resistance rates of the major species of the isolated pathogens, and the distribution of the pathogens was analyzed. RESULTS A total of 1616 strains of pathogens were isolated from Apr to Jul,2012; the top 4 species of pathogens isolated belonged to the gram-negative bacilli, including 216 （13.3%） strains of Acinetobacter baumannii, 196 （12. 1%） strains of Klebsiella pneumoniae, 194 （12. 0%） strains of Pseudomonas aeruginosa, and 177 （11.0%） strains of Escherichia coli. The E. colt strains were mainly isolated from urine （45.2%） and sputum （19.2%）, the rest of the pathogens were mainly isolated from sputum, with the detection rate varying between 73.0% and 83.5%. The drug resistance rates of K. pneumoniae and E. colt to piperacillin-tazobactam, amikacin, and imipenem were less than 18.0 %, the drug resistance rates to levofloxacin, ciprofloxacin, amoxicillin-clavulanic acid, cefoxitin, cefazolin, and ampicillin varied from 12.4% to 100.0%; the drug resistance rates of P. aeruginosa and A. baumannii to amikacin, levofloxaein, ciprofloxacin, eefepime, ceftazidime, gentamicin, tobramycin, imipenem, cefotaxime, sulfamethoxazole-trimethoprim, and piperacillin- tazobactam varied from 13.3 % to 100.0 %, moreover, the drug resistance rate of the A. baumannii was dramatically higher than that of the P. aeruginosa. CONCLUSION It is necessary for the hospital to dynamically monitor the drug resistance of the common pathogens and choose sensitive antibiotics in accordance with the characteristics of drug resistance so as to effectively control the infections.

关 键 词：病原菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]