2012年度某传染病专科医院感染细菌分布及耐药性分析  

Clinical distribution and drug resistance of pathogens causing nosocomial infection in an infectious diseases hospital in 2012

作　　者：何卫平[1] 崔恩博[2] 卜昕[1] 鲍春梅[2] 张文瑾[1] 范振平[1] 曲芬[2] 

机构地区：[1]解放军第三〇二医院军人肝病诊疗中心,北京100039 [2]解放军第三〇二医院临床检验医学中心,北京100039

出　　处：《传染病信息》2014年第1期45-48,共4页Infectious Disease Information

基　　金：全军医学科技"十二五"科研项目重点课题(BWS11C-073)

摘　　要：目的了解传染病专科医院患者感染细菌的分布及耐药性,为临床合理用药提供实验室依据。方法应用BacT/Alert誖3D血培养仪和血平板、中国蓝平板进行细菌分离培养,用VITEKⅡ全自动细菌鉴定系统及API鉴定条进行细菌鉴定。按美国临床和实验室标准协会推荐的Kirby-Bauer纸片扩散法进行药物敏感性试验,试验结果采用SPSS 13.0软件进行统计分析。结果在血液、尿液和腹水标本中最常见的致病菌是大肠埃希菌,而在痰标本中最常见的致病菌则是铜绿假单胞菌。革兰阴性菌对哌拉西林/他唑巴坦、头孢美唑和磷霉素等的耐药率低于20%,其中对头孢哌酮/舒巴坦、阿米卡星、米诺环素和亚胺培南/西司他丁的耐药率低于10%;革兰阳性菌对阿米卡星、呋喃妥因和奎奴普丁/达福普汀等的耐药率低于20%,其中对头孢吡肟、氯霉素、万古霉素和替考拉宁的耐药率低于10%。出现了耐万古霉素和替考拉宁的肠球菌。结论 2012年度某传染病专科医院主要院内感染细菌为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌和鲍曼不动杆菌;不同菌群的耐药性有很大差异。临床用药应密切结合患者的病情和感染特征及感染菌的耐药表型等综合情况,以制定合理的个体化治疗措施。Objective To investigate the distribution and drug resistance of pathogens causing uosocomial infection in an infectious diseases hospital and provide laboratory evidence for rational use of drugs in clinical practice. Methods BacT/Alert 3D automated blood culture system, blood dish and China blue agar dish were used for bacterial culture, and VITEK 2 automated identification system and API system for bacterial identification. Drug susceptibility were tested by Kirby-Bauer methods, and the results were analyzed by SPSS 13.0 statistical software. Results Escherichia coli was the most common in blood, urine and ascitic fluid samples and Pseudomonas aera^nosa was the most common in sputum samples. Antibiotic resistance of gram-negative bacteria was less than 20% to tazocillin, cefmetazole, fosfomycin and so on, and less than 10% to sulperazon, amikacin, minocycline and imipenem/cilastatin. Antibiotic resistance of gram-positive bacteria was less than 20% to amikacin, nitrofurantoin, quinupristin/ dalfopristin and so on, and less than 10% to cefepime, ehloramphenicol, vancomycin and teicoplanin. Vancomyciu-resistant and teicoplanin-resistant Enterococcus emerged. Conclusions The common bacteria causing nosocomial infection are Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii in an infectious diseases hospital in 2012. There are great differences in antibiotic resistance of bacteria. Patients＇ condition, infection characteristics and drug resistance of bacteria should be taken into consideration in clinical use of drugs, so as to make individualized treatment strategies.

关 键 词：抗药性 微生物 细菌感染 抗菌药 传染病 

分 类 号：R915[医药卫生—微生物与生化药学] R515[医药卫生—药学]