临床标本细菌分离及细菌耐药性监测  被引量:56

Bacteria Separated from Clinical Specimen and Their Drug Resistance

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作  者:古东东[1] 段蕴铀[1] 张红鹰[2] 郝秀红[1] 潘涛[1] 

机构地区:[1]海军总医院,北京100037 [2]北京军区总医院分院,北京100026

出  处:《中华医院感染学杂志》2003年第1期67-70,共4页Chinese Journal of Nosocomiology

摘  要:目的 连续对临床标本细菌分离和耐药性的监测分析 ,了解细菌分布及变迁 ,常见致病菌耐药性变化趋势。方法 对 1992~ 2 0 0 1年从临床标本分离 73 86株细菌统计及对常见细菌耐药率分析。结果 历年分离细菌中均以革兰阴性杆菌为主 (70 .2 1% ) ,由高到低的排序为铜绿假单胞菌、大肠埃希菌、克雷伯菌属 ;近 3年克雷伯菌属分离率明显增加。革兰阳性球菌中凝固酶阴性葡萄球菌分离率最高 ,占革兰阳性球菌的 3 8.3 2 %。铜绿假单胞菌对庆大霉素、头孢噻肟、氨苄西林 /舒巴坦、头孢曲松耐药率 >60 % ;哌拉西林、头孢噻肟、环丙沙星的耐药率由初期使用低耐药率分别增高到 2 0 0 1年的 44 .9%、83 .6%、47.6% ;近年来 ,大肠埃希菌对氟喹诺酮类耐药率为5 0 %~ 60 % ;革兰阳性球菌对常用抗菌药物耐药率均较高 ,在 2 0 0 1年的统计中金黄色葡萄球菌和凝固酶阴性葡萄球菌对青霉素耐药率已达 80 .5 %~ 82 .4% ;对苯唑西林凝固酶阴性葡萄球菌耐药率是 72 .0 %。结论 临床医师要重视细菌耐药性监测工作 ,掌握细菌变迁及细菌耐药性变化动向 。OBJECTIVE To study the distribution of and change in clinical bacteria, and the change in drug resistance of the common bacteria through continuous surveillance of the bacteria separated from clinical specimen and their drug resistance spectrum. METHODS To collect data of the 7386 strcina of bacteria separated from clinical specimen from 1992 to 2001, and make analyses on the drug resistance rate of the common bacteria. RESULTS The majority of bacteria separated from clinical specimen are Gram negative ons (70.21%), that are Pseudomonas aeruginosa, Escherichia coli, and Klebsiella in sequence. The separation rate of the Klebsiella is rising during the near three years. Among Gram positive cocci, the separation rate of coagulase negative staphylococci is the highest, which is 38.32 percent of the Gram positive cocci. The drug resistance rates of P.aeruginosa to gentamicin, cefotaxime, ampicillin/sulbactam and ceftriaxone are more than 60%; those to piperacillin, cefotaxime and ciprofloxacin have been increased from 4.1%, 25.0% and 5.0% of the earlier period to 44.9%, 83.6% and 47.6%, respectively in 2001. The drug resistance rates of E.coli to quinolones are between 50% and 60% in recent years. The drug resistance rates of the Gram positive cocci to commonly used antibiotics are very high, the drug resistance rates of the Staphylococcus aureus and coagulase negative staphylococci to penicillin are between 82.4% and 80.5%. The drug resistance rate of the coagulase negative staphylococci to oxacillin is 72.0%. CONCLUSIONS Doctors must pay attention to the bacteria drug resistance work, so as to know the change in bacteria and the change in their drug resistance, and improve the application of antibiotics at last.

关 键 词:临床标本 细菌分离 细菌耐药性 监测 

分 类 号:R446.5[医药卫生—诊断学] R978.1[医药卫生—临床医学]

 

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