2014年江苏省无锡市肿瘤医院临床分离病原菌的分布及耐药分析  

Analysis of distribution and drug resistance of pathogenic bacteria by clinical separation in Wuxi cancer hospital of Jiangsu province in 2014

作　　者：陆娟[1] 王忠明[1] 顾建兴[1] 

机构地区：[1]江南大学附属医院,214062

出　　处：《中国现代药物应用》2015年第11期37-39,共3页Chinese Journal of Modern Drug Application

摘　　要：目的了解本院临床分离病原菌的分布特点及耐药情况,为临床合理选用抗菌药物提供依据。方法收集本院临床标本中分离的病原菌2550株。采用VITEK2-compact全自动细菌分析仪进行鉴定和药敏试验,按美国临床和实验室标准协会(CLSI)2014年版标准判断结果。结果 2014年本院分离病原菌2550株,其中革兰阳性菌794株(占31.1%),革兰阴性菌1756株(占68.9%)。排列前三位的革兰阳性菌为金黄色葡萄球菌222株(8.7%)、表皮葡萄球菌114株(4.5%)、屎肠球菌62株(2.4%);排列前五位的革兰阴性菌为大肠埃希菌494株(19.4%)、铜绿假单胞菌490株(19.2%)、肺炎克雷伯菌322株(12.6%)、鲍曼不动杆菌304株(11.9%)、奇异变形杆菌60株(2.4%),以呼吸道、尿路、血液感染为主。其中耐甲氧西林金黄色葡萄球菌(MRSA)检出率为36%,对大环内酯类、喹诺酮类呈多重耐药,耐药率均>30%,而对氨基糖苷类耐药率<15%;葡萄球菌、屎肠球菌对万古霉素和利奈唑胺100%敏感。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的检出率分别为60.9%、34.0%;鲍曼不动杆菌及铜绿假单胞菌对碳青酶烯类的耐药率分别达47.4%和40.8%。结论 2014年本院分离病原菌耐药现象较为普遍,应加强临床抗菌药物的耐药监测,采取有效措施,延缓耐药菌的产生和蔓延。Objective To investigate the distribution and drug resistance of pathogenic bacteria by clinical separation in our hospital, in order to provide reference for clinically rational choice of antibacterial agents. Methods A total of 2550 strains of pathogenic bacteria by clinical separation in our hospital were collected. VITEK2-compact full-automatic bacteria analyzer was applied in detection and drug sensitive test, and the results were evaluated by clinical and laboratory standards institute （CLSI） 2014 criterion. Results A total of 2550 strains of pathogenic bacteria were separated, including 794 strains of gram positive bacteria （31.1%） and 1756 strains of gram negative bacteria （68.9%）. The top three in gram positive bacteria were 222 strains of staphylococcus aureus （8.7%）, 114 strains of staphylococcus epidermidis （4.5%） and 62 strains of enterococcus faecium （2.4%）. The top five in gram negative bacteria were 494 strains of escherichia coli （19.4%）, 490 strains of pseudomonas aeruginosa （19.2%）, 322 strains of klebsiella pneumonia （12.6%）, 304 strains of acinetobacter baumannii （11.9%）, and 60 strains of proteus mirabilis （2.4%）. Infection mainly occurred in respiratory tract, urinary tract, and blood. The detection rate of methicillin-resistant staphylococcus aureus （MRSA） was 36%. It showed multi-drug resistance to macrolides and quinolones, with drug resistance rate 〉30%, while its resistance rate to aminoglycosides was 〈15%. Staphylococcus and enterococcus faecium had 100% sensitivity for vancomycin and linezolid. Detection rates of escherichia coli and klebsiella pneumonia in extended spectyum [3 lactamase （ESBLs） were respectively 60.9% and 34.0%. Drug resistance rates of acinetobacter baumannii and pseudomonas aeruginosa to carbapenms were respectively 47.4% and 40.8%. Conclusion It is common for drug resistance in pathogenic bacteria by clinical separation in our hospital, thus strengthened monitoring on drug resistance and effective measures ,

关 键 词：耐药性 分布 细菌 

分 类 号：R446.5[医药卫生—诊断学]