摘要
目的了解我院2011-2013年病原菌检出情况和耐药性变迁趋势。方法对2011年1月-2013年12月我院住院患者送检的各类标本进行病原菌分离培养,同时用VTTEK2-Compact全自动细菌分析仪进行鉴定和药敏试验,按最新版本的CLSI标准对检出的27 399株病原菌进行回顾性分析。结果 27 399株病原菌中,革兰阳性菌检出7367株,占26.9%,前3位革兰阳性球菌分别是凝固酶阴性葡萄球菌、肠球菌属、金黄色葡萄球菌。革兰阴性菌检出14 815株,占54.1%,其中前6位分别是铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、阴沟肠杆菌、嗜麦芽窄食单胞菌。真菌检出5217株,占19.0%。凝固酶阴性葡萄球菌和金黄色葡萄球菌对苯唑西林的耐药率较低,在38.9%以下,对青霉素和红霉素的耐药率较高,分别在96.1%和84.9%以上。肠球菌对头孢唑啉100%耐药,对克林霉素的耐药率最低,在23.8%以下。肺炎克雷伯菌、大肠埃希菌和阴沟肠杆菌对碳青霉烯类抗生素亚胺培南的耐药率均较低,但呈逐年上升趋势。肺炎克雷伯菌对哌拉西林的耐药率最高,在99.7%以上,大肠埃希菌对哌拉西林和头孢唑啉的耐药率均较高,阴沟肠杆菌对头孢唑啉和氨苄西林/他唑巴坦的耐药率均较高,在90.7%以上。三种主要非发酵革兰阴性杆菌的耐药情况较严重,仅对米诺环素、多粘菌素B和头孢哌酮/舒巴坦的敏感性较高。结论我院感染以革兰阴性菌为主,细菌对抗菌药物的耐药性逐年增加。应动态监测本地区病原菌谱和耐药性变迁,合理选择抗生素,降低细菌的耐药性。
Objective To research pathogen detection and drug resistance change trend in our hospital from 2011 to 2013. Methods Pathogenic bacteria were isolated from kinds of specimens and were identified by VITEK2-Compact system. 27 399 strains pathogenic bacteria were retrospective analyzed by CLSI standard. Results In 27 399 strains pathogenic, 7367 strains gram positive coccus were isolated （26.9%）, and the top three were coagulase negative Staphylococcus, Staphylococcuz aureus and Enterocaccus. 14 815 strains gram negative bacilli were isolated （54.1% ）, and the top six were Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, A cinetobacter baumannii, Enterobacter cloacae, and Stenotrophomonas maltaphilia. 5217 strains were fungus （19.0%）. Drug resistant rates of coagulase negative Staphylococcus and Staphylococcus auretas to oxacillin were lower （under 38.9% ）, and to penicillin and erythrocin were higher （above 96.1% and 84.9% ）. Drug resistant rates of Enterococcus to cefazolin was 100.0%, and to clindamycin was lowest （under 23.8% ）. Drug resistant rates of Klebsiella pneumoniae, Escherichia coli and Enterobaeter cloacac to imipenem were lower, but which was on rise year by year. Drug resistant rate of KlebsieUa pneumoniae to piperacillin was highest （above 99.7% ）. Drug resistant rates of Escherichia coli to piperacillin and cefazolin were higher, and Enterobacter cloacae to cefazolin and ampicillin/tazobactam were higher （above 90.7% ）. Drug resistant situation of three main non-fermentative gram negative bacilli was serious, which had better sensitive to minocycline, polymyxin B and cefoperazone/sulbactam. Conclusion The hospital infection is given priority with gram-negative bacteria, the drug resistance of bacteria to antimicrobial drugs increased year by year. Should be dynamic monitoring the change of pathogens spectrum and drug resistance in our region, reasonable choice of antibiotics, reduce the drug resistance of bacteria.
出处
《实用检验医师杂志》
2014年第1期21-26,共6页
Chinese Journal of Clinical Pathologist
关键词
抗菌药物
病原菌
耐药性
革兰氏阳性球菌
革兰氏阴性杆菌
Antimicrobial agents
Pathogenic bacteria
Resistance
Gram positive coccus
Gram negative bacilli
