摘要
目的研究我院呼吸科病房临床分离菌分布和细菌耐药性变迁。方法回顾性分析2001年至2005年呼吸科病房送检的所有标本的细菌培养和药物敏感试验结果,每例患者只收集第1株分离菌。结果共收集分离菌876株,以革兰阴性菌为主。金葡萄中MRSA达72．4%,5年中呈增加趋势;未发现耐万古霉素的金葡菌和肠球菌;肺炎链球菌对青霉素的不敏感率为25%～66．7%,对左氧氟沙星的耐药率为22．2%～27．3%;肠杆菌科细菌和鲍曼不动杆菌对亚胺培南高度敏感,产ESBL大肠埃希菌株的分离率为33．3%～38．9%,肺炎克雷伯菌为14．3%～19．2%;2005年铜绿假单胞菌敏感率在70%以上的药物依次为头孢他啶87%、阿米卡星82．6%、头孢哌酮-舒巴坦78．3%、亚胺培南73．9%、哌拉西林三唑巴坦73．9%和头孢吡肟71．4%。结论呼吸科病房临床分离菌及细菌耐药性的变迁符合国内细菌耐药性变化的总体趋势,与患者基础疾病、病情严重程度和用药史等因素有关,对抗菌药物的选用具有指导意义。
Objective To explore the changes of pathogens and antibiotic susceptibility in a respiratory ward. Methods All pathogens isolated from patients in a respiratory ward from 2001 to 2005 and the drug susceptibility results were retrospectively analyzed. For patients with more than 1 isolates of the same species, only the first strain of pathogen was included for analysis. The isolation and identification procedure was based on guidelines for national clinical laboratories. The susceptibility test was performed by disk diffusion method. WHONET 5.3 software was used for statistical analysis. Results A total of 876 strains were analyzed. The majority was gram negative bacteria. MRSA prevalence was 72.4% and showed a trend of increase. No vancomycin resistant Staphylococcus aureus or Enterococcus was detected. Streptococcus pneurnoniae was highly resistant to macrolides. The non-sensitivity rate to penicillin was 25. 5%-66. 7% over years. The resistance rate to levofloxacin was 22.2%-27.3 %. Enterobacter and Acinetobacter baumannil showed stable susceptibility to imipenem. ESBLs-producing Escherichia coli and Klebsiella pneumoniae accounted for 33. 3%-38. 9% and 14. 3%-19. 2%respectively. P. aeruginosa strains were relatively susceptible to ceftazidime, amikacin, cefoperazone-sulbactam, imipenem, piperacillin-tazobactam and cefepime. The sensitivity rate was 87%, 82.6%, 78.3%, 73.9%, 73.9% and 71.4% respectively in 2005. Conclusions The changes of pathogens and antibiotic resistance in the respiratory ward were consistent with the surveillance data in this country, which were influenced by underlying diseases, severity of illness and antibiotic use. Our data are useful for the guidance of rational use of antibiotics.
出处
《中国感染与化疗杂志》
CAS
2007年第1期53-57,共5页
Chinese Journal of Infection and Chemotherapy
关键词
病原菌
细菌耐药性
呼吸科病房
Pathogen
Bacterial resistance
Respiratory ward
