2014年某医院感染病原菌的分布及主要病原菌耐药性监测  

Monitoring of drug resistance and distribution of pathogen in a hospital in 2014

作　　者：胡鑫[1] 赵德军[2,3] 徐鹏[4] 

机构地区：[1]贵航贵阳医院检验科遵义医学院附属300医院,贵州贵阳550009 [2]解放军第44医院检验科,贵州贵阳550009 [3]清镇市第一人民医院检验科,贵州清镇551400 [4]河北北方学院检验系,河北张家口075000

出　　处：《中国卫生检验杂志》2017年第7期1056-1059,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨某医院2014年收治患者感染病原菌的构成及耐药性,为医院感染的控制及临床合理应用抗菌药物提供参考依据。方法对患者送检的临床标本进行分离培养,并通过VITEK 2 Compact及ATB细菌鉴定分析仪进行病原菌的鉴定及药敏试验。结果共分离出病原菌2 393株,其中革兰阴性杆菌占62.4%;革兰阳性球菌占21.9%;真菌占15.7%。大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌及白色念珠菌占病原菌的前5位。大肠埃希菌、肺炎克雷伯菌产ESBLs的检出率分别为62.4%、41.6%,对亚胺培南、阿米卡星耐药率低;铜绿假单胞菌及鲍曼不动杆菌对多种抗菌药物的耐药率高于60.0%;葡萄球菌中MRSA、MRCNS的检出率分别为69.2%、73.6%,对万古霉素、利奈唑胺、替加环素100.0%敏感;白色念珠菌对抗真菌药物的耐药率低于5.0%。结论病原菌对部分抗菌药物耐药性严重,需要不断提高病原学送检及细菌耐药监测工作,以促进临床合理使用抗菌药物。Objective To investigate the composition and drug resistance of pathogenic bacteria in patients admitted to a hospital in 2014,so as to provide reference for the control of nosocomial infection and rational use of antibiotics in clinic.Methods The clinical specimens were isolated and cultured,and pathogen identification and drug sensitivity test were performed by VITEK 2Compact and ATB bacterial identification analyzer.Results A total of 2 393 strains of bacteria were isolated,gram-negative bacilli accounted for 62.4%,gram-positive cocci accounted for 21.9%,Fungi accounted for 15.7%.Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Pseudomonas aeruginosa and Candida albicans accounted for top 5 pathogens.The detection rates of Escherichia coli and Klebsiella pneumoniae＇s ESBLs were 62.4% and 41.6%,and had low drug resistance to imipenem,amikacin.Pseudomonas aeruginosa and Acinetobacter baumannii＇s drug resistance for a variety of antimicrobialis was higher than 60.0%; the detection rates of MRSA and MRCNS＇s in Staphylococci were 69.2% and 73.6%.Besides,they are100.0% sensitive to vancomycin,linezolid,tigecycline.The drug resistant rate of Candida albicans＇ s to the antifungal was below 5.0%.Conclusion The drug resistance of pathogenic bacteria is serious,so it is necessary to improve the pathogen detection and bacterial resistance monitoring,so as to promote the rational use of antibiotics in clinic.

关 键 词：病原菌 抗菌药物 耐药监测 

分 类 号：R446.5[医药卫生—诊断学]