医院感染病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens causing nosocomial infections

作　　者：孙佩玉[1] 贾雷[2] 陈猛[3,1] 

机构地区：[1]嘉兴市第一医院药剂科,浙江嘉兴314001 [2]嘉兴市第一医院院感科,浙江嘉兴314001 [3]嘉兴市第一医院

出　　处：《中华医院感染学杂志》2015年第1期45-47,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅省市共建医学扶持重点建设学科基金资助项目(GJJX-010-002)

摘　　要：目的了解目前医院感染病原菌分布及对抗菌药物的耐药率,为临床合理选用抗菌药物提供参考依据。方法采用VITEK系统或API系统进行菌株鉴定,细菌药物敏感性测定采用纸片扩散法(K-B法),真菌药物敏感性测定采用Rosco纸片法,使用WHONET5.6软件对药敏结果进行耐药性分析。结果 2013年共分离病原菌8 907株,其中革兰阴性菌4 750株占53.3%,革兰阳性菌1 680株占18.9%,真菌1 378株占15.5%;革兰阴性菌中的大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、美罗培南、阿米卡星较敏感,耐药率<10.0%;革兰阳性菌中的金黄色葡萄球菌、表皮葡萄球菌、粪肠球菌对庆大霉素、呋南妥因、利奈唑胺、万古霉素较敏感,耐药率<10.0%;假丝酵母菌属对抗真菌药物普遍较为敏感。结论检出病原菌以革兰阴性菌为主,耐药现象较为严重,应根据病原菌的分布及其耐药性合理选用抗菌药物。OBJECTIVE To investigate the distribution and drug resistance rates of pathogens causing nosocomial infections so as to provide guidance for reasonable clinical use of antibiotics.METHODS The bacterial identification was conducted by using VITEK system or API system,the drug susceptibility testing was performed for the anti-bacterial agents by using disk diffusion method （K-B method）and performed for the antifungal agents by using Rosco disk method,and the results of the drug susceptibility testing were analyzed by mean of WHONET5.6 soft-ware.RESULTS A total of 8 907 strains of pathogens have been isolated in 2013,including 4 750 （53.3%）strains of gram-negative bacteria,1 680 （18.9%）strains of gram-positive bacteria,and 1 378 （15.5%）strains of fungi. Among the gram-negative bacteria,the Escherichia coli,Klebsiella pneumoniae ,and Pseudomonas aeruginosa were highly susceptible to cefoperazone-sulbactam,piperacillin-tazobactam,imipenem,meropenem,and amikacin, with the drug resistance rates less than 10.0%;among the gram-positive bacteria,the Staphylococcus aureus, Staphylococcusepidermidis,and Enterococcusfaecalis were highly susceptible to gentamicin,linezolid,and van-comycin,with the drug resistance rates less than 10.0%;the Candidaspp was susceptible to the commonly used antifungal agents.CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated and are highly drug-resistant.It is necessary to reasonably use antibiotics on the basis of the distribution and drug resist-ance of the pathogens.

关 键 词：医院感染 病原菌 分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]