我院2009年2911株病原菌分布及耐药性分析

目的:分析江苏大学附属医院2009年临床分离细菌的构成及耐药性的动态变化。方法:采用Excel2003版软件对2009年临床各类标本培养分离出的病原菌的分布、构成和耐药性进行回顾性分析。结果:分离出2911株病原菌,其中革兰阴性杆菌2185株(75.06%),革兰阳性球菌536株(18.41%),真菌190株(6.53%);分离率位于前5位的病原菌是:铜绿假单胞菌(16.32%)、鲍曼不动杆菌(15.94%)、大肠埃希菌(12.09%)、肺炎克雷伯菌(11.78%)、金黄色葡萄球菌(10.86%)。革兰阳性球菌对万古霉素、替考拉宁、呋喃妥因敏感较好,但对其他抗菌药物敏感性不佳,耐苯唑西林金黄色葡萄球菌(MRSA)的耐药率为67.75%,未发现耐万古霉素葡萄球菌。革兰阴性杆菌对碳青霉烯类耐药性最低,但对部分抗菌药物产生多药耐药。结论:该院临床病原菌耐药呈上升趋势,多药耐药日趋严重,临床医师应根据药敏试验结果,及时掌握病原菌耐药谱的变化,合理选用抗菌药物。

Analysis of 2 911 Isolated Strains and Bacterial Resistance to Antibiotics in Our Hospital in 2009

Objective： To analyze the change of clinical isolated strains and bacterial resistance to antibiotics in the hospital affiliated to Jiangsu University in 2009.Methods： The distribution and the antimicrobial susceptibility of pathogens,which were collected and isolated from all of the clinical specimens in 2009 in our hospital,were analyzed retrospectively by microsoft Excel 2003 program.Results： Totally 2 911 strains of pathogens were isolated,among which 2185 strains were Gram-negative bacteria （75.06%）,536 strains were Gram-positive cocci （18.41%） and 190 strains were fungi （6.53%）.The five common bacteria were Pseudomonas aeruginosa（16.32%）,Acinetobacter baumanii （15.94%）,Escherichia coli （12.09%）,Klebsiella pneumoniae（11.78%）,and Staphylococcus aureus（10.86%）.Gram-positive cocci were more sensitive to vancomycin,teicoplanin,and nitrofurantoin than to other antibacteria.Meticillin-resistant S aureus（MRSA） accounted for 67.75%;vancomycin-resistant S aureus was not detected.Gram-negative bacilli had the lowest resistance to carbapenems,showing multi-resistance.Conclusion： Bacterial resistance is on the rise,and multi-resistance is getting more serious.Clinicians should control the change of drug-resistant spectrum of bacteria and conduct the rational use of clinical antibiotics according to drug susceptibility test.