355株临床分离病原菌的耐药性分析  

Drug Resistance of 355 Strains of Clinical Isolated Bacteria

作　　者：王文英[1] 叶明[2] 何蓓[3] 韩雪玲[3] 张亚萍[1] 杨喜民[2] 

机构地区：[1]解放军第三医院内分泌科,陕西宝鸡721004 [2]解放军第三医院检验科 [3]解放军第三医院感染科

出　　处：《解放军预防医学杂志》2017年第3期226-228,233,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：兰州战区引起血流感染的多重耐药菌分子流行病学研究课题(No.CLZ13JA08)

摘　　要：目的研究医院感染常见病原菌分布及耐药性,为临床诊治提供理论依据。方法选取某院2013年7月1日-12月31日临床分离的355株病原菌为试验对象,采用纸片扩散法(Kirby-Bauer法)分析药物的药敏反应。结果 355株临床分离菌中革兰阴性菌占65.9%(234株),革兰阳性菌占24.5%(87株),真菌占9.6%(34株)。标本来源以痰液为主,占58.6%(208株)。分离的大肠埃希菌以尿标本为主,占55.8%(29/52),肺炎克雷伯杆菌以痰标本为主,占34.6%(72/208)。产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯杆菌分别占70.3%(52/74)、56.5%(52/92)。产ESBLs株对测试的抗菌药物的耐药率均高于非产ESBLs株。未检测出对头孢吡肟、头孢哌酮/舒巴坦和亚胺培南耐药的大肠埃希菌和肺炎克雷伯杆菌的非产ESBLs菌。铜绿假单胞菌和鲍曼不动杆菌对头孢哌酮的耐药率分别为57.7%(30/52)、68.8%(11/16),对头孢哌酮/舒巴坦的耐药率分别为1.9%(1/52)、0。铜绿假单胞菌对其他所测试的抗菌药物耐药率均<35.0%,鲍曼不动杆菌对其他抗菌药物的耐药率均≥50.0%。耐甲氧西林金葡菌(MRSA)占54.0%(47/87),对氨苄西林/舒巴坦、克林霉素、利福平、头孢唑林、左氧氟沙星、头孢哌酮/舒巴坦和庆大霉素的耐药率均为100.0%。未检测出对万古霉素耐药的金黄色葡萄球菌。白色假丝酵母菌对抗真菌药耐药率均<10.0%。结论该院临床分离菌仍以革兰阴性菌为主,试验菌株对所测抗菌药物均具有不同程度的耐药,医院应及时做好病原菌耐药性监测,加强药品的管理和监控。Objective To provide reference for clinical diagnosis and treatment by studying the distribution and drug re- sistance of common pathogens causingnosocomial infections. Methods 355 strains of pathogens isolated between June l and De- cember 31 in 2013 at our hospital, were chosen as subjects for clinical trials. Antimierobial susceptibility testing was conducted u- sing Kirby-Bauer. Results Of the 355 strains of clinically isolated bacteria, Gram-negative bacteria accounted for 65, 9% （234 strains） , Gram-positive bacteria 24.5% （87 strains） , and fungus 9.6% （34 strains）. The main source of specimens was sputum that accounted for 58.6% （208 strains） , that of E. col was urine （ 55.8% ） （29/52）, and that of K. pneumoniae was sputum （34.6%） （72/208）. The prevalence of ESBLs was 70.3% （52/74） in E. coli and 56.5% （52/92） in K. pneumoniae. ESBLs- producing strains were more resistant to all antibiotics than non-ESBLs-producing strains. The non-ESBLs-producing strains of E. col and K. pneumoniae were not detected, which were resistant to cefepime, cefoperazone/sulbactam and imipenem. The drug resistance rate of Pseudomonas aeruginosa and Acinetobacter baumannii to cefoperazone was 57.7% （30/52） and 68.8% （11/ 16） respectively, but was 1.9% （1/52）and 0 respectively to cefoperazone/sulbactam. The drug resistance rate of Pseudomonas aeruginosa to other tested antibacterial agents was below 35.0% , while that of Acinetobacter baumannii to other tested antibacteri- al agents was above 50.0%. MRSA accounted for 54.0% （47/87） ,and its drug resistance rate to ampicillin/sulbactam, clinda- myein, rifampicin, eefazolin, levofloxacin, cefoperazone/sulbactam and gentamiein was 100.0%. No staphylococcus aureus was detected, which was resistant to vancomycin. The drug resistance rate of Candida albicans to antifungal agents was below 10. 0%. Conclusion The main clinically isolated bacterium is still Gram-negative bacteria in our hospital, and the drug resistance rate of these

关 键 词：病原菌 抗菌药物 耐药性 药敏试验 

分 类 号：R378[医药卫生—病原生物学]