2013年某院主要感染细菌的分布及耐药分析  

Distribution and drug resistance of nosocomial infectious bacteria in certain hospital in 2013

作　　者：李军[1] 杨爱慈 

机构地区：[1]山东省济宁市第一人民医院检验科,济宁市272111 [2]山东省济宁市嘉祥县人民医院肾内科,济宁市272400

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第5期108-111,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的调查医院感染细菌的分布及耐药分析，为临床合理用药提供参考依据。方法分析2013年1月至2013年12月本院院内感染细菌的分布及耐药情况。使用法国生物一梅里埃ATB细菌鉴定系统，应用药敏测试仪及配套微生物检测试剂进行细菌鉴定和药敏试验。结果临床分离出的5251株感染菌中，革兰阴性杆菌3689株（占70．25％），革兰阳性杆菌1348株（占25．67％），真菌214株（占4．08％）。菌株比例位居前5名的依次为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、肺炎链球菌和肺炎克雷伯菌，标本来源主要是痰液、分泌物、尿液和血液等。肠杆菌科细菌对亚胺培南和美罗培南的耐药率均低于10．0％，另外，对酶抑制剂复合制剂、头霉素类、阿米卡星，以及呋喃妥因具有很好的抗菌活性。非发酵革兰阴性菌中，铜绿假单胞菌对常用抗菌药物的耐药率均〈27．8％，鲍曼不动杆菌对常用抗菌药物的耐药率均〉41．7％。革兰阳性球菌对青霉素类、大环内酯类耐药率高达77．7％～98％。耐甲氧西林金葡菌（MRSA）和耐万古霉素肠球菌（VI匝）的检出率分别为49．64％和2．13％。结论该院临床分离菌耐药现象严重，应加强病原菌的耐药性监测。Objective To investigate the distribution of hospitalized infection bacteria and to analyze the drug resistance, to provide basis for the reasonable clinical of antibiotics. Methods The distribution of bacterial infection and antibiotic resistance data from January 2013 to December 2013 were analyzed. The bacterial identification and susceptibility testing were taken by French biology-biomerieux ATB bacterial identification system, susceptibility detection instrument and supporting microbial detection reagent. Rsults A total of 5 251 clinical isolates were collected, among which there were 3 689 （70.25%） strains of Gram negative bacteria, 1 348 （25.67%） strains of Gram postive bacteria, and 214 （4.08%） strains of fungi. The top five bacterias were Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae and Streptococcus pnemoniae, mainly from sputum, throat swabs, secretions, blood and urine. Less than 10% of the Enterobacteriaceae strains were resistant to imipenem or meropenem. In additional, compound preparation of [3-1actamase inhibitor, amikacin and cephamycin displayed desirable antibacterial activity against Enterbacteriaceae. For nonfermenting Gram negative isolates, less than 27.8% of the P aeruginosa isolates were resistant to commonly used antibiotics. More than 41.7% of the Acinetobacter baumannii strains were resistant to commonly used antibiotics. The resistant rate of Gram positive bacteria to penicillin and macrolide antibiotics was as high as 77.7%-98.0%. The rates of MRSA and VRE were 49.64% and 2.13%, respectively. Conclusions Antibiotic resistance is serious in the clinical bacterial isolates in certain hospital, and the monitoring should be strengthened.

关 键 词：耐药性 细菌 细菌分布 耐药性监测 

分 类 号：R446.5[医药卫生—诊断学]