2013-2015年郑州市中医院临床常见病原菌分布及耐药性分析  

Distribution and drug resistance of common pathogenic bacteria in the Hospital of Traditional Chinese Medicine of Zhengzhou from 2013 to 2015

作　　者：韩忠敏[1] 王敏[1] 

机构地区：[1]郑州铁路职业技术学院医学技术系,河南郑州451460

出　　处：《现代预防医学》2016年第18期3406-3408,3412,共4页Modern Preventive Medicine

摘　　要：目的了解2013-2015年临床细菌分布和耐药性,为临床合理使用抗菌药物提供依据。方法对2013-2015年临床病原菌分布及耐药性进行回顾性研究。采用珠海迪尔医学细菌测定系统对4 439株病原菌进行细菌鉴定和药敏试验。结果 2013-2015年临床共分离4 439株病原菌,革兰阴性菌占78.3%,革兰阳性菌占17.6%,真菌占4.1%,其中革兰阴性菌前4位依次为铜绿假单胞菌(22.2%)、肺炎克雷伯菌(16.5%)、大肠埃希菌(15.3%)和鲍曼不动杆菌(9.5%)。药敏结果显示,临床常见病原菌对大部分抗菌药物有不同程度耐药且特点各不相同。3年中铜绿假单胞菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢吡肟、阿米卡星、多黏菌素B和氨曲南的耐药率始终低于30%,平均耐药率分别为13.2%、17.5%、18.4%、9.5%、4.8%和8.1%。鲍曼不动杆菌对多黏菌素B耐药率最低,为4.7%;耐药率增幅最大的为阿米卡星,耐药率由2013年的27.8%上升至2015年的75.0%。未发现对亚胺培南耐药大肠埃希菌。肺炎克雷伯菌对美罗培南和亚胺培南的耐药率分别为17.4%和16.6%。57.4%大肠埃希菌和18.8%肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs),泛耐药鲍曼不动杆菌(PDR)检出率为1.3%。未检出对万古霉素耐药革兰阳性球菌。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为40.9%。结论医院感染病原菌以革兰阴性菌为主且耐药率较高,需加强细菌耐药性监测,为合理用药提供依据。Objective This study was to investigate the distribution and drug resistance of pathogens from 2013 to 2015, so as to provide reference for the rational use of antibiotics. Methods The distribution and drug resistance of the pathogens during 2013-2015 were retrospectively analyzed. A total of 4439 isolated pathogenic bacteria were identified and their drug sensitivity were analyzed by the auto microbial ID/AST analyzer from Zhuhai DL Medical Biotech Co.LTD. Results 4439 strains were isolated from clinical samples, including Gram-negative bacteria （78.3%）, Gram-positive bacteria （17.6%） and fungi （4.1%）. P.aeruginosa （22.2%）, K.pneumoniae （16.5%）, E.coli （15.3%） and A.baumannii （9.5%） were the top four Gram-negative bacteria. The drug sensitivity test showed that the common pathogenic bacteria had different degrees of resistance to many antibiotics. The resistance rate of P.aeruginosa to cefoperazone/sulbactam, piperacillin/tazobactam, cefepime, amikacin, polymyxin B and aztreonam was less than 30.00% in these three years. The average resistance rate to them was 13.2%, 17.5%, 18.4%, 9.5%, 4.8% and 8.1%. The resistance rate of P.aeruginosa to polymyxin B was less than 10.00% in these three years, with an average of 4.7%. The drug resistance to amikacin increased from 27.8% in 2013 to 75.0% in 2015. E.coli showed no resistance to imipenem. Klebsiella pneumoniae had 17.4% and 16.6% resistance to meropenem and imipenem. The prevalence of ESBLs producing strains was 57.4% in E.coli and 18.8% in Klebsiella pneumoniae. The detection rate of PDR was 1.33%. All Gram-positive coccus were sensitive to vancomycin. The detection rate of MRSA was 40.9%. Conclusion The Gram-negative bacteria were dominant among pathogens isolated and were highly durg-resistant. Drug resistance monitoring should be strengthened in order to provide reference for the rational use of antibiotics.

关 键 词：病原菌 耐药监测 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]