新疆乌苏地区常见病原菌的监测及耐药性分析  

Clinical Monitoring of Common Pathogens and Drug Resistance in Wusu of Xinjiang

作　　者：尚丽霞[1] 史颖[1] 王栋[1] 

机构地区：[1]乌苏市解放军第十五医院检验科,新疆乌苏833000

出　　处：《现代检验医学杂志》2014年第4期135-138,共4页Journal of Modern Laboratory Medicine

摘　　要：目的 了解新疆乌苏地区常见病原菌的分布及耐药情况,为临床合理用药提供依据.方法 回顾分析2011～2013年间临床分离的1 961株病原菌的分布及耐药情况.结果 病原菌的来源以伤口分泌物、尿液和痰液为主,分布以革兰阴性杆菌为主,占57.07％,革兰阳性球菌和真菌各占40.74％和2.1s％.主要的病原菌是大肠埃希菌、凝固酶阴性的葡萄球菌、金黄色葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和肠球菌等.大多数病原菌对头孢哌酮/舒巴坦、亚胺培南、阿米卡星敏感率高（敏感率＞70％）,对青霉素、红霉素、克林霉素、氨苄西林和一、二代头孢菌素耐药率高（耐药率＞70％）,还发现了部分泛耐药菌.肠杆菌属对三代头孢菌素类、喹诺酮类的耐药率低于非发酵菌属,酶抑制剂能明显降低革兰阴性杆菌的耐药率,未发现万古霉素耐药菌株.葡萄球菌耐甲氧西林菌株、肠杆菌科产超广谱β内酰胺酶（ESBL）菌株的检出率呈逐年上升趋势.结论 细菌的耐药状况形势严峻,临床医师应结合病原菌耐药监测结果,合理、有效、正确的使用抗菌药物,避免耐药菌株的产生.Objective Comprehending the distribution and drug resistance of pathogenic bacteria in Wusu of Xinjiang,in order to instruct clinical rational administration.Methods Retrospective analysis of the distribution and drug resistance in 1 961 pathogens of clinical isolates from 2011 to 2013.Results Pathogenic bacteria＇s main resource are oral secretion,sputum and urine;the main distribution is Gram negative bacilli （57.07％）,the second is Gram positive coccus （40.74％） and fungus （2.19 ％）.Main bacteria were E.coli,coagulase negative Staphylococci,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii and Enterococci so on.Drug sensitivity assay indicate that in the grampositive cocci,Staphylococcus has the highest drug resistance （resistance rate ＞ 70 ％） to penicillin,erythromycin,clindamycin,the most sensitivity （sensitive rate ＞ 70 ％） to imipenem; enterococcus was resistant to most antibacterial agents,but sensitive to imipenem and ampicillin,found no vancomycin resistant strains.Thedetection rate of Methicillin-resistant Staphylococcus strains and Fnterobacteriaceae producing extended spectrum β lactamase （ESBL） strains were in upward trend of yearly.Conclusions The situation of bacterial drug resistance is severe,clinicians should combine the drug resistance monitoring results of pathogenic bacteria in this region reasonable,effective and correct use of antibacterial drugs,in order to avoid the generation of drug resistant strains.

关 键 词：病原菌 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]