摘要
目的监测住院患者常见病原菌的分布及耐药特征,指导临床合理应用抗菌药物。方法采用MicroScanAutoScan-40半自动微生物鉴定仪和药敏系统及配套进行菌株鉴定与药物敏感性测定,并检测超广谱β-内酰胺酶(ESBLs)及耐甲氧西林金黄色葡萄球菌(MRSA),用WHONET5软件进行数据统计分析。结果 1439株临床分离菌株中革兰阴性杆菌965株占67.1%,主要为大肠埃希菌、克雷伯菌属、鲍氏不动杆菌、铜绿假单胞菌,大肠埃希菌和肺炎克雷伯菌产ESBLs分别为55.3%%和32.8%;革兰阴性杆菌对大多数抗菌药物耐药;革兰阳性球菌223株占15.5%,主要为金黄色葡萄球菌、凝固酶阴性葡萄球菌、肠球菌属,葡萄球菌属、肠球菌属耐药率较高,尚未检测到万古霉素耐药株;真菌251株占17.4%,其中以白色假丝酵母菌为主。结论医院临床分离的病原菌种类多且耐药率高,以革兰阴性菌为主、革兰阳性球菌及真菌感染有增多趋势;临床应重视病原学检查及根据药敏结果合理应用抗菌药物,以减少病原菌耐药的发生。
OBJECTIVE To investigate the antibiotic resistance and distribution of pathogens isolated from the hospitalized patients and guide the rational use of antimicrobials.METHODS The bacterial identification and antibiotic susceptibility testing were carried out by using MicroScan AutoScan-40 system and testing for ESBLs and MRSA;the data were analyzed by WHONET 5 software.RESULTS Of 1439 clinical isolates,totally 965（67.1%） gram-negative bacilli were isolated,mainly including Escherichia coli,Klebsiella pneumoniae,Acinetobacter spp,and P.aeruginosa;the detection rates of ESBLs-producing E.coli and K.pneumoniae strains were 55.3 % and 32.8%,respectively;gram-negative bacilli were resistant to most antibiotics;there were 223（15.5%） strains of gram-positive cocci detected,mainly including Staphylococcus aureus,coagulase-negative Staphylococci,Enterococcus,and Staphylococcus,the resistance rate of Enterococcus was high,and no vancomycin-resistant strains were identified;there were 251（17.4 %） strains of fungi isolated,among which Candida albicans was dominant.CONCLUSION There are various species of clinical isolates with the high drug resistance rates,gram-negative bacteria are predominant pathogens,and the infections caused by gram-positive cocci and fungi keep an increasingly upward tendency;it is necessary to attach great importance to the etiology examination and the reasonable use of antibiotics on the basis of drug susceptibility testing so as to decrease the drug resistance.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第9期1906-1908,共3页
Chinese Journal of Nosocomiology
关键词
病原菌
抗菌药物
耐药性
监测
Pathogen
Antibacterial agent
Drug resistance
Surveillance
