四川省人民医院老年科病原菌分布及耐药性分析  

Bacterial distribution and drug resistance at geriatrics department of Sichuan provincial people's hospital

作　　者：奉婷[1] 唐荣珍[1] 喻华[2] 杜恒健[1] 蔡敏泓[1] 

机构地区：[1]四川省医学科学院.四川省人民医院老年感染科,四川成都610072 [2]四川省医学科学院.四川省人民医院检验科,四川成都610072

出　　处：《实用医院临床杂志》2015年第6期87-89,共3页Practical Journal of Clinical Medicine

摘　　要：目的了解四川省人民医院老年科临床送检标本病原菌的分布特点及耐药特点,指导临床合理用药。方法对2012年四川省人民医院老年科临床分离标本的来源、病原菌分布及耐药性等资料进行统计分析。结果 2598株病原菌中,革兰阴性菌株占78.91%,革兰阳性菌株占21.09%。分离前五位分别是铜绿假单胞菌、大肠埃希菌、克雷伯氏菌属、不动杆菌属和柠檬酸杆菌属。革兰阴性菌中,大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)株分别为55.86%和35.4%,肠杆菌科细菌对碳青霉烯类抗生素的耐药性<3.8%。铜绿假单胞菌对亚胺培南耐药率为66.96%,对阿米卡星、哌拉西林/他唑巴坦耐药率较低,分别为4.16%和13.69%。鲍曼不动杆菌对亚胺培南耐药率为58.74%。革兰阳性菌中,耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率分别为65.82%和79.23%。肠球菌中粪肠球菌和屎肠球菌分别占16.67%和83.33%。发现2株耐万古霉素的MRCNS和2株耐万古霉素肠球菌。结论我院老年科患者感染以呼吸道感染为主,细菌耐药性日趋严重,碳青霉烯类抗生素对肠杆菌科细菌仍有较高的抗菌活性。Objective To investigate the distribution and antibiotic resistance of clinical isolates from geriatrics department of Sichuan Provincial People＇s Hospital during 2012 in order to guide the clinical treatment. Methods The source of the culture specimens,distribution of pathogens,and the drug resistance were taken for statistical analysis from January to December in 2012. Results A total of 2598 strains of pathogens were isolated including the gram-negative microorganisms and gram-positive microorganisms accounting for 78. 91% and 21. 09%,respectively. The first occupying five clinical isolates were Pseudomonas aeruginosa,Escherichia coli,Pneumobacillus,Acinetobacter and Citrobacter. About 55. 86% of Escherichia coli and 35. 4% of Klebsiella pneumoniae were ESBLs-producing strains. The resistance rate of Escherichia coli against carbapenems was less than 3. 8%. The resistance rate of Pseudomonas aeruginosa against imipenem was 66. 96%,while against amikacin and piperacillin/tazobactam were relative？ low（ 4. 16% and13. 69%,respectively）. The resistance rate of Acinetobacter baumannii against imipenem was 58. 74%. The detection rates of Methicillin-resistant Staphylococcus aureus（ MRSA） and Coagulase-negative Staphylococcus（ MRCNS） were 65. 82% and 79. 23%,respectively. The prevalence of E. faecalis strains and E. faecium in enterococcus was 16. 67% and 83. 33%,respectively. There were two strains of MRCNS and two strains of E. faecium resistant to vancomycin. Conclusion The geriatric infection was dominated by respiratory system infection in our hospital. The antibiotic resistance is increasing seriously. The antibacterial activity of Escherichia coli against carbapenems is still high. We should strengthen the surveillance of bacterial resistance,and use antibiotics reasonably.

关 键 词：病原菌 细菌耐药性 抗菌药 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]