2012-2013年病原菌分布与对抗菌药物的药敏分析  

Distribution and drug susceptibility of pathogens during 2012-2013

作　　者：王华光[1] 冯频频 宫丽丽[1] 刘河[1] 刘丽宏[1] 

机构地区：[1]首都医科大学附属北京朝阳医院药事部,北京100020

出　　处：《中华医院感染学杂志》2016年第1期52-55,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81302822)

摘　　要：目的分析住院患者常见病原菌的药敏性及抗菌药物的用药频度（DDDs）,为临床合理应用抗菌药物提供参考。方法对医院2012年1月1日-2013年12月31日住院患者病原菌分离株及其对抗菌药物的药敏性进行回顾性分析,用纸片扩散法（K-B法）,部分细菌使用VITEK系统配套的药敏卡进行药敏试验;同时计算抗菌药物的DDDs。结果共分离病原菌9 189株,其中革兰阴性菌6 784株、革兰阳性菌2 405株;分离的前5位病原菌分别为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌和凝固酶阴性葡萄球菌;革兰阳性球菌对万古霉素、替考拉宁、利奈唑胺的敏感率较高,约100.0%;甲氧西林敏感金黄色葡萄球菌（MSSA）对克林霉素的敏感率最低,且呈明显下降趋势;鲍氏不动杆菌对所有抗菌药物的敏感性均呈明显下降趋势;大肠埃希菌对氟喹诺酮类的敏感率仅为24.8%-40.9%。结论鲍氏不动杆菌耐药日趋严重,其他革兰阴性菌和革兰阳性菌的耐药趋势较稳定;抗菌药物的DDDs与细菌耐药性无确定关系;加强对鲍氏不动杆菌的耐药性监测,结合药敏试验调整用药,对控制细菌耐药性及促进临床合理用药具有重要意义。OBJECTIVE To investigate the drug susceptibility of the common pathogens and the daily defined doses（DDDs）of antibiotics so as to provide guidance for reasonable clinical use of antibiotics.METHODS The pathogens were isolated from the patients who were hospitalized from Jan 1,2012 to Dec 31,2013,then the drug susceptibility of the strains was retrospectively analyzed,the disk diffusion method（K-B method）was employed,the drug susceptibility testing of some strains was performed by using drug susceptibility card matched to VITEK system,and the DDDs of the antibiotics were calculated.RESULTS A total of 9 189 strains of pathogens were isolated,including 6 784 strains of gram-negative bacteria and 2 405 strains of gram-positive bacteria;the Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter baumannii,and coagulase-negative Staphylococcus ranked the top five species of the isolated pathogens.The drug susceptibility rate of the gram-positive cocci to vancomycin,teicoplanin,and linezolid was about 100.0%;the drug susceptibility rate of the methicillin-sensitive Staphylococcus aureus（MSSA）to clindamycin was the lowest and showed a significant downward trend;the drug susceptibility rate of the A.baumannii to all the antibiotics showed a significant downward trend;the drug susceptibility rate of the E.coli to fluoroquinolones varied from 24.8%to 40.9%.CONCLUSIONThe drug resistance of the A.baumannii is increasingly severe,while the drug resistance of other gram-negative bacteria and gram-positive bacteria is relatively stable;there is no definite relationship between the DDDs of antibiotics and the bacterial drug resistance.It is of great significance to strengthen the surveillance of drug resistance of the A.baumannii and adjust the administration of antibiotics based on the drug susceptibility testing so as to control the bacterial drug resistance and promote the reasonable clinical use of antibiotics.

关 键 词：病原菌 耐药趋势 敏感性 抗菌药物 用药频度 

分 类 号：R378[医药卫生—病原生物学]