天津市南开医院6年来感染病原菌菌谱及耐药性监测

目的:调查临床分离病原菌菌谱及耐药特征,为临床合理使用抗菌药物提供依据。方法:采用Bio-Merieux VITEK-ams细菌自动分析仪对临床分离的菌株进行鉴定,采用纸片扩散法进行药敏试验,按CLS1标准判定药敏结果。结果:非重复临床分离的10868株菌中,革兰阴性菌占63.45%,革兰阳性菌占27.21%;真菌占9.34%;大肠埃希菌和肺炎克雷伯菌的ESBLs的检出率分别为53.46%和41.20%。各种肠杆菌科细菌对亚胺培南仍高度敏感。铜绿假单胞菌对碳青霉烯类药物的耐药率为43%以上。MRSA及MRSCON的分离率分别为65.41%和75.98%,未发现万古霉素耐药株。结论:医院感染病原菌仍以革兰阴性菌为主,已出现泛耐药株;真菌检出率较高,但耐药性处于较低水平。

Surveillance of Pathogenic Spectrum and Drug Resistance in Hospital Infections

Objective To investigate the characteristics of pathogenic spectrum and drug resistance,and to provide evidences of reasonable application of antibiotics.Methods Bacterial strains isolated from clinical samples were identified by bio-Merieux VITEK-ams,subjected to drug susceptibility test by Kirby-Bauer meth od.and the drug sensitivity determined by CLSI.Results In the 10868 bacterial strains isolated from clinical samples,the distribution rate of different gram-negative bacteria was 63.45%,the distribution rate of differentgram-positive bacteria was 27.21%,and that of fun gus was 9.34%.Those of Escherichia coli and Klebsi ella pneumoniae producing ESBLs were 53.46% and 41.20% respectively.Imipenem was highly sensitive to En terobacteriaceae.About Pseudomonas aeruginosa,the rate of resistance to Carbapenem drugs was more than 43%,and the rates of MRSA and MRSCON were 65.41% and 75.98% respectively.No strain resistance to vancomycin was found.Conclusion Pathogens of nosocomial infection were mainly gram negative bacteria.Emergence of resistant strains has been found.The fungus positive rate was high,but drug resistance rate was low.