2014年度西京医院病原菌分布特点及其耐药性分析  

Analysis of distribution and drug resistance of nosocomial pathogenic bacteria in Xijing Hospital in 2014 annual

作　　者：郑恬[1] 徐修礼[1] 陈潇[1] 周珊[1] 冯乐欣 白露[1] 

机构地区：[1]第四军医大学西京医院检验科,西安710032

出　　处：《中华临床医师杂志（电子版）》2015年第22期65-69,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：2014年陕西省自然科学基础研究计划项目(2014JM4188)

摘　　要：目的分析2014年度西京医院临床常见病原菌分布特点和对抗菌药物的耐药情况,指导临床合理使用抗菌药物。方法采用常规方法对临床感染标本进行病原菌培养、分离和鉴定,药敏试验应用K-B纸片扩散法,参照CLSI M100-S23规定的标准执行。试验结果应用WHONET 5.6软件进行统计分析。结果 2014年1至12月共检出病原菌6 322株,其中肠杆菌科菌2 396株(分离率37.90%),需氧革兰阳性球菌1 782株(分离率28.19%),非发酵菌1 662株(分离率26.29%),真菌346株(分离率5.47%),苛养菌120株(分离率1.90%),厌氧菌16株(分离率0.25%)。大肠埃希菌1 171株中超广谱β-内酰胺酶(ESBLs)770株,产酶率为65.76%;肺炎克雷白菌599株中ESBLs 210株,产酶率为35.06%。金黄色葡萄球菌888株中耐甲氧西林金黄色葡萄球菌458株(检出率51.58%),凝固酶阴性葡萄球菌193株中耐甲氧西林凝固酶阴性葡萄球菌122株(检出率63.21%)。分离的病原菌以大肠埃希菌、金黄色葡萄球菌、鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷白菌为主,占分离率的64.50%。主要肠杆菌科菌对头孢曲松、环丙沙星、头孢吡肟、头孢哌酮/舒巴坦、亚胺培南、美洛培南的耐药率分别为55.76%、48.60%、19.30%、5.59%、4.47%、4.27%;铜绿假单胞菌和鲍曼不动杆菌对头孢他啶、头孢吡肟、哌拉西林/他唑巴坦、环丙沙星、亚胺培南、多黏菌素B的耐药率分别为51.27%、50.70%、50.49%、49.51%、48.03%、0%;葡萄球菌对红霉素、克林霉素、左氧氟沙星、米诺环素、呋喃妥因、万古霉素、利奈唑胺的耐药率分别为81.13%、52.27%、40.80%、5.09%、1.85%、0%、0%;肠球菌对红霉素、青霉素、左氧氟沙星、米诺环素、呋喃妥因、万古霉素、利奈唑胺的耐药率分别为87.65%、68.31%、66.26%、33.33%、24.49%、1.03%、0%。耐甲氧西林金黄色葡萄球菌及耐甲氧西林凝固酶阴性葡萄球菌对头孢西丁的耐药率为53.65%。结论医院感Objective To analyze the distribution characteristics and drugs resistance of common pathogenic bacteria isolated from clinical specimens in Xijing hospital in 2014 annual, so as to guide the clinical use of antibiotics rationally. Methods All of clinical specimens from January 2014 to December 2014 were cultured, and the pathogenic bacteria were isolated and identified by routine methods. Drug sensitivity test K-B disk diffusion was underwent according to the CLSI M100-S23 of the recommendation. The experimental data were analyzed with statistical software WHONET version 5.6. Results A total of 6 322 strains of pathogens were isolated, including 2 396 of Enterobacteriaceae (isolation rate, 37.90%), 1 782 of aerobic Gram-positive Cocci (isolation rate, 28.19%), 1 662 of non-fermentative bacteria (isolation rate, 26.29%), 346 of fungi (isolation rate, 5.47%), 120 of fastidious bacteria (isolation rate, 1.90%), and 16 of anaerobic bacteria (isolation rate, 0.25%). 770 of 1 171 strains of Escherichia coli, 210 of 599 strains of Klebsiella pneumoniae, were identified as ESBLs-producing bacteria, and both enzyme producing rates were 65.76% and 35.06% respectively. 458 of 888 strains of Staphylococcus aureus were identified as MRSA (detection rate, 51.58%). While, 122 of 193 strains of coagulase-negative Staphylococcus were identified as MRCNS (detection rate, 63.21%). Escherichia coli, Staphylococcus aureus, Bauman acinetobacter, and Pseudomonas aeruginosa, were mainly isolates as a distribution characteristics of pathogens in this study. And their isolation rate was 64.50%. Of main Enterobacteriaceae, drug resistant rates to ceftriaxone, cefepime, ciprofloxacin, cefoperazone/shubatan, imipenem and Meropenem were 55.76%, 19.30%, 48.60%, 5.59%, 4.47% and 4.27%, respectively. Of Pseudomonas aeruginosa and acinetobacter Baumanas, drug resistant rates to ceftazidime, cefepime, piperacillin/tazobactam, ciprofloxacin, and imipenem were 51.27%, 50.70%, 50.49%, 49.51%, and 48.03%respectively. Of Staphylococcus, drug resi

关 键 词：医院感染 病原菌 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]