2013年重庆医科大学附属某医院临床分离病原菌的分布及耐药性分析  

Analysis on distribution and drug resistance of clinically isolated pathogenic bacteria in a affiliated hospital of Chongqing Medical Universit during 2013

作　　者：李代昆[1] 罗根[1] 李莉[1] 余雪梅[1] 李文明[1] 刘定华[1] 刘欢[1] 赵钰玫 吴啸天[1] 薛建江[1] 

机构地区：[1]重庆医科大学附属大学城医院检验科,重庆401331

出　　处：《重庆医学》2016年第6期747-751,共5页Chongqing medicine

基　　金：重庆市卫生局课题(2012-2-146)

摘　　要：目的探讨临床标本分离病原菌的分布及耐药性特征,为临床合理使用抗菌药物提供依据。方法对该院2013年临床送检的细菌检验标本1 936份进行细菌培养、鉴定和药敏试验,药敏试验结果判定依据临床和实验室标准协会(CLSI)颁布标准,采用实验室信息系统(LIS)进行数据分析。结果1 936份临床标本共检出病原菌461株,其中革兰阴性杆菌234株(50.76%),革兰阳性球菌123株(26.68%),真菌104株(22.56%)。常见病原菌为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、表皮葡萄球菌、粪肠球菌、鲍曼不动杆菌。对于肠杆菌科细菌,亚胺培南美、洛培南和阿米卡星的抗菌活性最强;万古霉素和替考拉宁是葡萄球菌属敏感性最高的药物;对于非发酵菌,敏感的药物有亚胺培南和美洛培南等。大肠埃希菌和肺炎克雷伯菌中超广谱β-内酰胺酶的检出率为10.42%和5.00%,耐甲氧西林金黄色葡萄球菌为26.32%,耐甲氧西林凝固酶阴性葡萄球菌为70.00%。结论临床分离的细菌耐药状况比较严重,临床医生应重视病原菌的药物监测,了解细菌耐药性的变迁,合理选择和使用抗菌药物。Objective To investigate the distribution and drug resistance characteristics of clinically isolated pathogenic bacteria in order to provide the basis for rational clinical use of antibacterial drugs.Methods Clinically submitted specimens for detecting bacteria during 2013 were performed bacterial culture,identification and antimicrobial susceptibility testing.The standards promulgated by the Clinical and Laboratory Standards Institute（CLSI）were used as the judgment basis of the antimicrobial susceptibility test results,and the data were analyzed by adopting the laboratory information system（LIS）.Results A total of 461 strains of pathogenic bacteria were detected,including 234 strains of Gram negative bacilli（50.76%）,123 strains of Gram positive cocci（26.68%）and 104 strains of fungi（22.56%）.The common pathogenic bacteria included E.coli,P.aeruginosa,S.aureus,K.pneumoniae,S.epidermidis,E.faecalis and A.baumannii.For enterobacteriaceae bacteria,imipenem,meropenem and amikacin had the strongest antibacterial activity;vancomycin and teicoplanin were the most sensitive drugs for Staphylococcus;nonfermenting bacteria were sensitive to imipenem and meropenem.The detection rates of extented spectrumβ-lactamases（ESBLs）in E.coli and K.pneumonia were 10.42% and 5.00% respectively.Methicillin resistant S.aureus accounted for 26.32% and methicillin resistant coagulase negative staphylococcus accounted for 70.00%.Conclusion The drug resistance status of clinically isolated bacteria is increasingly serious.Clinical doctors should pay attention to monitoring of pathogenic bacteria,understand the change of bacterial drug resistance,rationally select and use antibacterial drugs.

关 键 词：病原菌 耐药性 分布特征 

分 类 号：R446.5[医药卫生—诊断学]