摘要
目的：分析医院感染病科细菌培养阳性患者常见病原菌的分布以及菌株对常用抗生素的敏感性，为细菌感染临床诊治提供参考。方法回顾性分析2013年1月至2015年12月医院感染病科送检标本中阳性菌株的构成、不同标本的分布及所有的药敏结果；样本包括血液、尿液、痰液；菌种鉴定及药敏分析分别采用 VITEK 细菌鉴定及药敏分析系统进行。结果本研究时间段内共分离出280株病原菌。在检出病原菌的样本方面，前三位依次是血液（32.9％，92株）、痰液（26.8％，75株）和尿液（11.4％，32株）。在检出的菌种方面，革兰阴性杆菌占48.9％，革兰阳性球菌占22.1％，真菌占28.9％；革兰阴性杆菌中大肠埃希菌占20.4％，肺炎克雷伯菌占6.4％，鲍曼不动杆菌占2.9％，布氏杆菌占12.9％；革兰阳性球菌中，凝固酶阴性葡萄球菌占6.4％，屎肠球菌占4.6％，金黄色葡萄球菌占3.9％，链球菌属占3.6％；真菌中，白色念株菌占12.9％，克柔念珠菌占2.1％，曲霉菌占4.6％。药敏实验方面，大肠埃希菌对亚胺培南耐药率为0％，肺炎克雷伯菌和鲍氏不动杆菌对亚胺培南耐药率分别为5.6％和12.5％；未发现对万古霉素和利奈唑胺耐药的葡萄球菌，肠球菌（屎肠球菌和粪肠球菌）对万古霉素耐药率为5.6％；喹诺酮类药物对革兰阳性球菌的抗菌活性差，尤其是肠球菌属对喹诺酮类药物的耐药率＞94.0％；链球菌对青霉素耐药率为10.0％。结论感染科阳性菌主要经血液培养获得；革兰阴性杆菌是就诊患者的主要病原菌；细菌敏感的抗菌药物谱窄，耐药性严重；真菌的药物敏感性较好。
Objective To analyze the clinical distribution and the drug resistance of pathogenic bacteria in the infectious department and to provide the evidence for clinical therapy. Methods Bacterial culture of all samples in infection department from January 2013 to December 2015. The species identifi-cation and drug sensitivity tests were performed using VITEK automatic systems,then the proportion of the strains and the distribution among the specimens and the results of sensitivity to antibiotics were ana-lyzed. Results A total of 280 pathogens were isolated. In terms of the detection of the positive speci-mens,the three most common ones were in turn the blood（32. 9% ,n = 92 ）,the sputum（26. 8% , n = 75）and urine（11. 4% ,n = 32）. In the detection of strains,gram-negative bacilli accounted for 48. 9% ,gram positive bacteria accounted for 22. 1% ,fungi accounted for 28. 9% . Among the gram neg-ative bacteria,Escherichia coli accounted for 20. 4% ,klebsiella pneumonia accounted for 6. 4% ,acine-tobacter baumannii accounted for 2. 9% ,brucella accounted for 12. 9% . Among the gram positive bacte-ria,coagulase negative staphylococci accounted for 6. 4% ,enterococcus faecium accounted for 4. 6% , staphylococcus aureus accounted for 3. 9% ,streptococcus accounted for 3. 6% . Among the fungi,candi-da albicans accounted for 12. 9% ,candida krusei accounted for 2. 1% ,aspergillus accounted for 4. 6% . In drug sensitivity test,the resistance rate of Escherichia coli to imipenem was 0% ,klebsiella pneumoni-ae and acinetobacter baumannii to imipenem were 5. 6% and 12. 5% ,no vancomycin and linezolid re-sistant Staphylococcus aureus was found,the resistant rate of enterococcus to vancomycin was 5. 6% . The antibacterial activity of gram positive bacteria was poor by quinolones drugs,especially the drug resist-ance of enterococcus to quinolones was 〉 94. 0% . The resistance rate of streptococcus pneumoniae to penicillin was 10. 0% . Conclusions Gram-negative bacteria are the major pathogens isolated from infec-tion depa
出处
《中国实用医刊》
2016年第24期106-109,共4页
Chinese Journal of Practical Medicine
关键词
感染病科
病原菌
耐药分析
Infectious department
Pathogenic bacteria
Drug resistance
