2015年临床分离病原菌分布及耐药性分析  

Distribution and drug resistance analysis of pathogenic bacteria isolated from clinical specimens in 2015

作　　者：侯伟伟[1] 江涟[1] 李冬[1] 

机构地区：[1]同济大学附属同济医院检验科,上海200065

出　　处：《外科研究与新技术》2016年第2期91-95,共5页Surgical Research and New Technique

摘　　要：目的了解同济医院分离病原菌的临床特征及耐药情况,为临床医师合理应用抗生素提供依据。方法采用VITEK-2 Compact全自动微生物分析仪鉴定临床菌株,采用WHONET 5.6分析软件对2015年分离的病原菌进行回顾性分析。结果 2015年共检出病原菌2 924株;其中,革兰阴性菌占69.6%(2 036/2 924),革兰阳性球菌占30.4%(888/2 924)。标本种类以痰液、尿、血标本和分泌物为主。病原菌主要分离自ICU,其次为门诊、普外科、泌尿外科和呼吸科。在革兰阴性菌中,鲍曼不动杆菌和肺炎克雷伯菌对碳青霉烯类抗生素耐药比较严重;大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶菌株对抗生素耐药率多高于非产超广谱β-内酰胺酶菌株。在革兰阳性菌中,甲氧西林耐药葡萄球菌对抗生素的耐药率普遍高于甲氧西林敏感葡萄球菌。结论 2015年临床细菌耐药仍较严重;为控制感染和临床合理应用抗生素,耐药监测工作刻不容缓。Objective To investigate the clinical characteristics and drug resistance of pathogenic bacteria in Tongji Hospital,and provide evidence for rational use of antibiotics in clinics. Methods VITEK-2 Compact was used to identify the clinical strains. WHONET 5.6 software was adopted to retrospectively analyze the clinical isolates of pathogens in 2015. Results A total of 2 924 non-repetitive messages of bacteria were collected in 2015. The prevalence of gram-negative bacteria was 69.6%（2 036/2 924）,and that of gram-positive bacteria was 30.4%（888/2 924）. Most of the bacteria were isolated from sputum,urine,blood and secretion specimens. Departments of ICU was the main endemic area of bacteria,followed by Department of Outpatient,Department of General Surgery,Department of Urology and Department of Respiratory Medicine. For gram-negative bacteria,the Carbapenem-resistace of Acinetobacter baumannii and Klebsiella pneumonia was still serious. For Escherichia coli and Klebsiella pneumoniae,the drug resistance of ESBLs-positive Escherichia coli and Klebsiella pneumoniae was more serious than the ESBLs-negative Escherichia coli and Klebsiella pneumoniae. For gram-positive bacteria,the resistance rate of methicillin-resistant staphylococcus was higher than that of methicillin-sensitive staphylococcus. Conclusion The bacterial drug resistance is still serious in the clinical setting in the year of 2015. Monitoring antimicrobial resistance has important significance to control infection and guide clinical rational drug use.

关 键 词：细菌 临床特征 耐药性 耐药监测 

分 类 号：R446.5[医药卫生—诊断学]