摘要
目的了解本院病原菌分布及其耐药性趋势,为临床合理使用抗菌药物提供依据。方法对2011年1月-2012年1月门诊和住院患者送检的临床标本1 643份进行细菌培养及药物敏感性检测,并对其细菌耐药性进行分析。结果 1 643份细菌培养标本中共检出致病菌750株,检出阳性率为45.6%;病原菌中,G+球菌242株,占32.3%,以金黄色葡萄球菌、凝固酶阴性葡萄球菌、肠球菌属为主。G杆菌382株,占50.9%,以大肠埃希菌、铜绿假单胞菌、克雷伯菌属、肠杆菌属、鲍曼不动杆菌为主。耐甲氧西林金黄色葡萄球菌占金黄色葡萄球菌的59.0%。金黄色葡萄球菌对青霉素、头孢唑啉耐药率均为100.0%。肠球菌属中分离率最高的为粪肠球菌和屎肠球菌,粪肠球菌对青霉素的耐药率为35.3%。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶检出率分别为77.6%和56.7%;非发酵菌以铜绿假单胞菌和鲍曼不动杆菌为主,耐碳青酶烯类鲍曼不动杆菌分离率占鲍曼不动杆菌37%。鲍曼不动杆菌、铜绿假单胞菌对亚胺培南的耐药率分别为46.3%、28.3%。结论本院细菌耐药性较高,应加强抗菌药物的合理应用,应谨慎使用第三代头孢菌素等β-内酰胺类抗菌药物,以减轻抗生素的选择性压力、防止耐药菌株在医院内播散。
Objective To learn the distribution and drug-resistance trend of pathogenic bacteria in our hospital,in order to provide basis for correct use of clinical antimicrobial agents.Methods Between January 2011 and January 2012,we performed bacterial culture and drug sensitivity test for 1643 clinical specimens coming from both outpatients and inpatients,and analyzed drug resistance of the bacteria.Results Among the 1 643 bacterial culture specimens,we found a total of 750 strains of pathogenic bacteria,indicating a positive rate of 45.6%.Among the pathogenic bacteria,there were 242 strains of G＋ cocci,occupying 32.3% with a majority of staphylococcus aureus,coagulase negative staphylococcus and enterococcus genera;there were 382 strains of G-bacilli,occupying 50.9% with a majority of escherichia coli,pseudomonas aeruginosa,klebsiella pneumoniae,enterobacter and acinetobacter baumannii.Methicillin resistant staphylococcus aureus（MRSA） accounted for 59.0% of staphylococcus aureus.And the drug resistance rate of staphylococcus aureus to penicillin and cefazolin were both 100.0%.Among the enterococcus,dung enterococcus and shit enterococcus were of the highest separation rate.The drug resistance rate of dung enterococcus to penicillin was 35.3%.The detection rates of escherichia coli and klebsiella pneumoniae producing ESBL（Extended-spectrum beta-lactamase） were 77.6% and 56.7% respectively;non-fermentative bacteria consisted mainly of pseudomonas aeruginosa and baumanii,and the separation rate of olefinic kind of acinetobacter baumannii resisting carbon blue mould from acinetobacter baumannii was 37%.The drug resistance rates of acinetobacter baumannii and pseudomonas aeruginosa to imipenem were 46.3% and 28.3% respectively.Conclusions In our hospital,the bacterial drug resistance is high.Reasonable application of antimicrobial agents should be strengthened;the use of the third generation cephalosporins and other beta lactam kind of antibacterial drugs should be careful in order to reduce antibiotic selective pressure to prevent drug-resistant strains within the hospital.
出处
《华西医学》
CAS
2013年第2期249-252,共4页
West China Medical Journal
关键词
病原菌
抗菌药物
耐药性
Pathogenic bacteria
Antibacterial agents
Drug resistance
