2011年医院临床病原菌分布及耐药性分析

目的了解九江市第三人民医院临床分离病原菌的分布特点及抗菌药物耐药趋势,为临床合理用药提供依据。方法对医院2011年1-12月临床所采集各类标本1 768份进行细菌培养、分离、鉴定和药敏试验,对结果进行统计分析。结果 1 768份标本共分离出病原菌946株,以痰、分泌物标本的分离率最高。病原菌分布以革兰阴性杆菌为主,占50.7%（480/946）,革兰阳性球菌占34.5%（326/946）,真菌占14.8%（140/946）;革兰阴性杆菌对亚胺培南、哌拉西林/他唑巴坦、阿米卡星、头孢他啶表现出较好的敏感性,对氨苄西林、头孢唑啉、头孢曲松耐药率较高;革兰阳性球菌对万古霉素敏感率为100%,对其他抗生素耐药率均较高。产超广谱B-内酰胺酶（ESBLs）检出率为50.2%,耐甲氧西林金黄色葡萄球菌（MRSA）检出率为52.3%,未发现万古霉素耐药菌株。结论临床分离病原菌存在多重耐药情况,应加强抗生素药物的合理使用,采取有效的隔离措施以降低耐药率及多重耐药菌的扩散。

Distribution and Drug Resistance of Clinical Pathogens in Hospital in 2011

Objective To investigate the distribution and drug resistance of pathogens isolated from clinical specimens in the third people＇s hospital of Jiujiang, and to provide a reasonable reference for clinical use of antibiotics. Methods The culture, isolation, identification and antimicrobial susceptibility test of clinical pathogens were performed in 1 768 clinical specimens in our hospital from January to December 2011. Results were analyzed statistically. Results A total of 946 strains of pathogenic bact- eria were isolated among the 1 768 specimens. Sputum and secretion specimens had the highest separation rate. Gram-negative bacilli, gram-positive cocci and fungi accounted for 50.7% （480/946）, 34.5%（326/ 946） and 14.8% （140/946）of the isolates, respectively.Good susceptibility of imipenem,piperacillin/ tazobactam, amikacin, ceftazidime against gram-negative bacilli were be showed, while the pathogen showed high resistance to Ampicillin, Cefazolin and ceftriaxone; Gram-positive cocci were sensitive to vancomycin was 100%, but the rest of antibiotics resistance rates were higher The detection rates of extended-spectrum β- lactamases （ESBLs）and methicillin-resistant Staphylococcus aureus （MRSA）were 502% and 52.3%, respectively. No vancomycin-resistant strains were found. Conclusion Clinical isolates of pathogens were multi-drug resistant. Reasonable use of antibiotics should strengthened and effective control measures should be taken for reducing the drug resistance and preventing the spread of multi-drug resistant pathogens