无菌体液的细菌分布和耐药性监测  

Surveillance of Bacterial Distribution and Resistance in Sterile Body Fluids

作　　者：王亚飞[1] 弓艳娥[1] 黄玮[1] 李晖[1] 郭步平[1] 郭旭霞[1] 

机构地区：[1]长治医学院附属和平医院检验科,046000

出　　处：《长治医学院学报》2014年第1期27-31,共5页Journal of Changzhi Medical College

摘　　要：目的：了解无菌体液（尿液、血液、胸腹水、伤口分泌物等）的细菌分布和对抗菌药物的耐药性.方法：收集无菌体液680株非重复细菌,用纸片扩散法进行药物敏感试验,结果按CLSI 2012版标准判读药敏结果,采用WHONET5.6软件进行数据分析.结果：680株非重复菌中,革兰氏阴性菌404株,占59.4%,革兰氏阳性菌276株,占40.6%,伤口分泌物标本所占比例最高（30.6%）,其次为尿液（25.4%）、血液（17.9%）.前5位分离菌依次为大肠埃希菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌,分别为34.0%、20.1%、9.1%、7.6%、5.3%.金葡菌和凝固酶阴性葡萄球菌对甲氧西林的耐药率分别为22.6%和61.2%.未发现对利奈唑胺和万古霉素耐药的葡萄球菌和肠球菌.肠杆菌科细菌对亚胺培南和美罗培南仍100%敏感.鲍曼不动杆菌对亚胺培南和美罗培南的敏感率均为57.9%,对头孢类抗生素敏感率为5.6%~23.5%.铜绿假单胞菌对亚胺培南和美罗培南的敏感率分别为97.1%和100%.结论：无菌体液标本主要病原菌为大肠埃希菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌,预防感染应根据药物敏感实验合理使用抗菌药物.Objective：To investigate the distribution and antimicrobial drug resistance of the bacteria isolated from sterile body fluids from Affiliated Heping Hospital of Changzhi Medical College from July to December in 2012.Methods：Disc diffusion test（Kirby-Bauer method）,MIC test and E-test were used to detect the drug susceptibility.The data were analyzed by WHONET 5.6 software according to CLSI 2012 breakpoints.Results：A total of 680 non-duplicate clinical isolates were collected from July to December in 2012,of which gram negative organisms and gram positive organisms accounted for 59.4%（404/680） and 40.6%（276/680）,respectively.The top three specimen types were the wound infections （30.6%）,urine（25.4%） and blood（17.9%）.The top five pathogens were Escherichia coli （34.0%）,coagulase negative staphylococcus（CNS,20.1%）,Staphylococcus aureus （9.1%）,Klebsiella pneumonia（7.6%）, Pseudomonas aeruginosa （5.3%）.The drug resistance rate of the S.aureus and CNS strains to methicillin were 22.6% and 61.2%,respectively.No staphylococcal strain and enterococcal strain were found resistant to vancomycin and linezolid.No family enterobacteriaceae strain was found resistant to imipenem and meropenem.The susceptibility rates of Acinetobacter baumannii to imipenem and meropenem were both 57.9% and the susceptibility rate to cephalosporanic antibiotics was between 5.6% to 23.5%.The susceptibility rates of P.aeruginosa to imipenem and meropenem were 97.1% and 100%,respectively.Conclusion：The leading pathogenic bacteria isolated from sterile body fluid are E.coli,CNS,S.aureus,K.pneumonia and P.aeruginosa.More attention should be paid to the threats caused by the those bacteria.

关 键 词：细菌耐药性监测 细菌分布 药敏试验 无菌体液 

分 类 号：R446.5[医药卫生—诊断学]