摘要
目的探讨某院临床近年主要病原菌分布及耐药性,为临床合理用药提供依据。方法收集该院2008年1月—2010年12月分离自门诊及住院患者的病原菌资料,对其构成及耐药性作统计分析。结果共分离病原菌7 008株,其中革兰阴性菌3 961株(56.52%),革兰阳性菌1 582株(22.57%),真菌1 465株(20.91%);居前3位的病原菌依次为白假丝酵母菌(1 015株,15.00%)、铜绿假单胞菌(906株,12.93%)、大肠埃希菌(874株,12.47%)。2008—2010年,金黄色葡萄球菌中耐甲氧西林株总检出率为85.07%(678/797),凝固酶阴性葡萄球菌中耐甲氧西林株总检出率为73.17%(150/205);大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶株的总检出率分别为64.19%(561/874)、46.31%(301/650)。金黄色葡萄球菌对万古霉素、替考拉宁敏感,对复方磺胺甲口恶唑敏感率(68.42%～74.51%)较高,对其余抗菌药物敏感率均<30%;凝固酶阴性葡萄球菌对万古霉素、替考拉宁敏感;大肠埃希菌和肺炎克雷伯菌对亚胺培南和美罗培南敏感率(95.52%～100.00%)最高,大肠埃希菌对第三代头孢菌素头孢噻肟、头孢曲松、头孢哌酮和氟喹诺酮类环丙沙星、左氧氟沙星敏感率均<30%。3年铜绿假单胞菌对头孢他啶和美罗培南的敏感率均较高,分别为60.31%～85.83%、59.38%～73.23%。结论该院分离的主要病原菌对常用抗菌药物耐药性普遍较高,应加强监控,合理使用抗菌药物,有效预防和控制医院感染的发生。
Objective To investigate the distribution and antimicrobial resistance of pathogens from patients in a hospital , and provide basis for rational use of antimicrobial agents. Methods Data about bacterial strains isolated from inpatients and outpatients in a hospital from January 2008 to December 2010 were collected , distribution and antimicrobial resistance of pathogens were analyzed. Results A total of 7 008 bacterial strains were isolated, 3 961 （56. 52%） isolates were gram-negative bacteria , 1 582 （22. 57%） were gram-positive bacteria, and 1 465 （20. 91%） were fungi; the top three pathogens were Candida albicans （1 015 isolates, 15. 00%） ,Pseudomonas aeruginosa （906 isolates, 12. 93%）,Escherichia coli （874 isolates, 12. 47%）. Methicillin-resistant Staphylococcus aureus （MRSA） accounted for 85.07%（678/797） of all Staphylococcus aureus, methicillin-resistant eoagulase-neg- ative Staphylococcus （MRCNS） accounted for 73. 17% （150/205） of all CNS; the isolation rate of extended-spec trum β-lactamase （ ESBLS）-producing Escherichia coli and Klebsiella pneumoniae was 64. 19% （ 561/874 ） and 46. 31%（301/650） respectively. Staphylococcus aureus isolates were sensitive to vancomycin and teicoplanin, the resistant rate to sulfamethoxazole/trimethoprim was 68. 42% - 74. 51%, the resistant rate to the other agents were all 〈30 % ; isolates of CNS were sensitive to vancomycin and teicoplanin; Escherichia coli and Klebsiella pneumoniae had highest sensitive rate to imipenem and meropenem （95.52% - 100. 00%）, the resistant rate of Escherichia coli to cefotaxime, ceftriaxone, cefoperazone , eiprofloxacin, and levofloxacin were all 〈30%. Pseudomonas aerugi- nosa had relative higher resistant rate to ceftazidime （60. 31% - 85. 830/oo） and meropenem （59. 38% - 73. 23%）. Conclusion Antimicrohial resistance of major pathogens isolated from patients in this hospital were generally high. It should pay more attention to the monitoring of multi-drug resistant strains, antimicrobial agents should be used rationally.
出处
《中国感染控制杂志》
CAS
2013年第1期54-58,共5页
Chinese Journal of Infection Control
基金
2011年焦作市科技局基金课题(焦科[2011]92-9)
关键词
病原菌
抗菌药物
抗药性
微生物
医院感染
合理用药
pathogen
antimicrobial agent
drug resistance, microbial
healthcare-associated infection
rational drug use
