重庆某区临床常见病原菌分布及耐药性分析  

Analysis on clinical common pathogenic bacterial distribution and drug resistance in a district of Chongqing City

作　　者：蔡静 夏庆宇 Cai Jing Xia Qingyu(Department of Clinical Laboratory, Bishan District Hospital of Traditional Chinese Medicine, Chongqing 402760, China Bishan District People＇s Hospital, Chongqing 402760, China)

机构地区：[1]璧山区中医院,重庆402760 [2]璧山区人民医院,重庆402760

出　　处：《现代医药卫生》2017年第15期2259-2262,共4页Journal of Modern Medicine & Health

摘　　要：目的了解重庆市璧山区常见病原菌分布情况及其对常用抗菌药物的耐药特点,指导临床合理使用抗菌药物。方法选取2014年1月至2015年12月璧山区人民医院和璧山区中医院门诊及住院患者的全部送检标本6 949株,对常见病原菌及其耐药性等进行回顾性分析。结果 2014年检出3 512株病原菌,其中革兰阳性菌512株(14.6%),革兰阴性菌2 600株(74.0%);2015年检出3 437株病原菌,其中革兰阳性球菌509株(14.8%),革兰阴性杆菌2 445株(71.1%)。革兰阳性球菌中以金黄色葡萄球菌为主,2014、2015年阳性率分别为6.8%、9.6%;其中2014、2015年耐甲氧西林金黄色葡萄球菌检出率分别为27.1%、27.2%。2014年大肠埃希菌产超广谱β-内酰胺酶(产ESBLs)阳性检出率为55.2%,肺炎克雷伯菌产ESBLs阳性株检出率为27.6%;2015年大肠埃希菌产ESBLs阳性检出率为68.2%,肺炎克雷伯菌产ESBLs阳性株检出率为27.4%。结论临床医生应提高检验标本的送检意识,采取有效的感染控制措施、合理用药,避免多重耐药菌株的产生。Objective To understand the distribution situation of common pathogenic bacteria and their resistance characteristics to commonly used antibacterial drugs in Bishan District of Chongqing City so as to guide rational use of antibacterial drugs in clinic. Methods A total of 6 949 submitted samples from the inpatients of our two hospitals from January 2014 to December 2015 were selected. Then the common pathogenic bacteria and their drug resistance were retrospectively analyzed.Results A total of 3 512 strains of pathogenic bacteria were detected in 2014,including 512 strains（14.6%） of Gram positive bacteria and 2 600 strains（74.0%） of Gram-negative bacteria;3 437 strains of pathogenic bacteria were detected in 2015,including 509 strains（14.8%） of Gram positive bacteria and 2 445 strains（71.1%） of Gram-negative bacteria. Gram positive bacteria were dominated by Staphylococcus aureus,its positive rates in 2014 and 2015 were 6.8% and 9.6% respectively;in which the MRSA detection rate was 27.1% in 2014 and 27.2% in 2015. The positive detection rate of ESBLs producing Escherichia coli was55.2% in 2014,which of ESBLs producing Klebsiella pneumoniae was 27.6%;the positive detection rate of ESBLs producing Escherichia coli was 68.2% in 2015,which of ESBLs producing Klebsiella pneumoniae was 27.4%.Conclusion Clinical doctors should increase the submission awareness of inspection samples,adopt the effective infection control measures,rationally use antibacterial drugs and avoid the generation of multidrug resistant bacteria.

关 键 词：革兰氏阳性菌 抗菌药 药物耐受性 克雷伯菌 肺炎 

分 类 号：R181.34[医药卫生—流行病学]