2013年昆明某院临床分离致病菌的分布及耐药分析  

Analysis of distribution and drug resistance of clinical isolated pathogenic bacteria in a hospital of Kunming during 2013

作　　者：张渝 邵天波[2] 陈瑞春[2] 杜艳[2] 

机构地区：[1]云南省普洱市人民医院检验科,云南普洱665000 [2]昆明医科大学第一附属医院检验科,云南昆明650032

出　　处：《国际检验医学杂志》2015年第11期1565-1567,1570,共4页International Journal of Laboratory Medicine

摘　　要：目的：了解2013年昆明医科大学第一附属医院临床分离致病菌的分布特点及耐药情况。方法收集2013年1～12月该院临床标本中分离的致病菌4266株，采用 VITEK2型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化协会（CLSI）2012年版标准判断结果，应用 Whonet 5．6软件进行统计分析。结果4266株致病菌中革兰阳性菌1487株（占34．8％），革兰阴性菌2779株（占65．2％）。排列前三位的革兰阳性菌为葡萄球菌、肠球菌和溶血性链球菌；排列前三位的肠杆菌科细菌为大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌。以呼吸道标本、尿液标本、血液标本为主。其中耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌检出率分别为30．1％和62．8％，未发现耐万古霉素和利奈唑胺的葡萄球菌，但出现了对替考拉宁中介的葡萄球菌；屎肠球菌和粪肠球菌对万古霉素的耐药率分别为0．6％和0．7％，屎肠球菌未发现利奈唑胺耐药，而粪肠球菌对利奈唑胺的耐药率为0．7％。产超广谱β‐内酰胺酶（ESBLs）大肠埃希菌及肺炎克雷伯菌的检出率分别为57．4％和33．3％，大肠埃希菌及肺炎克雷伯菌对亚胺培南的耐药率分别为0．8％和17．5％；鲍曼不动杆菌对常用抗菌药物的耐药率达50．0％以上，铜绿假单胞菌对常用的有抗假单胞菌活性的药物耐药率小于25．0％。结论2013年度该院分离细菌耐药现象较为普遍，开展细菌耐药性监测，对指导临床合理使用抗菌药物，降低医院内感染率和控制细菌耐药性有重要意义。Objective To investigate the distribution and drug resistance to commonly used antibiotics of clinical isolates ob‐tained from the First Affiliated Hospital of Kunming Medical University .Methods A total of 4 266 bacteria strains isolated from clinics were collected .Identification and drug susceptibility test were performed by VITEK2 automatic analysis system and the re‐sults were analyzed according to the standard published by the Clinical and Laboratory Standards Institute （CLSI） using Whonet 5 .6 software .Results A total of 4 266 bacterial were isolated including 2 779（65 .2% ） gram‐negative strains and 1 487（34 .8% ） gram‐positive strains .The top three gram‐positive strains were Staphylococci ,Enterococcus and Streptococcus hemolyticus .The top three Enterobacteriaceae were Escherichia coli ,Klebsiella pneumoniae and Enterobactercloacae .The top three sample type were re‐spiratory tract specimens ,urine specimens ,blood specimens .The detection rates of methicillin‐resistant Staphylococcus aureus and coagulase‐negative Staphylococcus were 30 .1% and 62 .8% respectively .No vacomycin and linezolid resistant Staphylococcus strains were found .However ,intermediary Staphylococcus strains was found .The resistance rates of Enterococcus faecium （EFM ） and Enterococcus faecalis （EFA） to vancomycin were 0 .6% and 0 .7% respectively .No linezolid‐resistant EFM was found .Howev‐er ,The resistance rates of EFA to linezolid was 0 .7% .The resistance rates to imipenem of E .coli and Klebsiella pneumoniaeisolates were 0 .8% and 17 .5% respectively .The resistance rate of Acinetobacter baumannii to commonly used antibiotics was more than 50 .0% ,while the drug resistance of pseudomonas aeruginosa was lower than 25 .0% .Conclusion Drug resistance of bacterial isola‐ted from this hospital is a common phenomenon ,it is important to use antibacterial agents rationally to reduce the rate of hospital infection and control the bacterial drug resistance .

关 键 词：标本 细菌 抗菌药物 耐药监测 

分 类 号：R446.5[医药卫生—诊断学]