镇江市三所二级医院监测病原菌分布及耐药性分析

目的对镇江市3所二级医院临床标本细菌分离和耐药性进行监测分析,了解病原菌的分布、常见致病菌耐药性变化趋势。方法对2002~2004年从临床标本分离出1 661株细菌统计及常见细菌耐药率分析。结果1 661株细菌中革兰阳性细菌634株,占38.2%,其中以凝固酶阴性表皮葡萄球菌为首312株,其次凝固酶阳性金黄色葡萄球菌有148株;两种葡萄球菌的耐药率相似,对青霉素及苯唑西林的耐药率>85%,对红霉素>75%,对头孢菌素类和喹诺酮类>30%和35%,对万古霉素耐药率为零;革兰阴性细菌1 027株,占61.8%,前5位依次为肠杆菌属249株、克雷伯菌属226株、埃希菌属167株、铜绿假单胞菌136株、变形菌属62株;前5位革兰阴性细菌对常用抗菌药物的耐药性以半合成青霉素较明显,变形菌属的耐药率较突出。结论临床医师、实验人员、医院感染监测部门要高度重视细菌耐药性监测工作,掌握细菌变迁及细菌耐药性变化动向,提高抗菌药物合理使用水平。

Pathogen Distribution and Drug-resistance to Antibacterial Agents Detected in Three Second-class Hospitals in Zhenjiang

OBJECTIVE To isolate bacteria from three second-class hospitals in Zhenjiang Jiangsu Provine,to detect their drug(-resistance) to antibacterial(agents) and analyzed the results in order to find out pathogen distribution and drug(-resistance) trend of the common causative organism.METHODS We isolated 1661 strains of bacteria from clinical samples between 2002 and 2004,and analyze their drug-resistance.RESULTS The number of Gram-positive(bacteria) was 634,accounting for 38.2%,from them there were 312 strains of coagulase-negative Staphylococcus epidermidis,and 148(coagulase)-positive S.aureus.Drug-fast of two above staphylococci was similar.The(resistance) rate to penicillin and to oxacillin surpassed 85%,that to erythromycins exceeded 75%,to quinolones and cephalosporins surpassed 30% and 35%,respectively.The resistance rate to(vancomycin) was zero.Gram-(negative) bacteria were 1 027 strains,accounted for 61.8%.(According) to quantity order,the first was Enterobacter(249 strains);then were Klebsiella(226 strains);Escherichia(167 strains);Pseudomonas aeruginosa(136 strains);and Proteus(62 strains).The resistant rate to semisyhthesized penicillins among the first five Gram-(negative) bacteria species,was the most,especially the Proteus.CONCLUSIONS Clinical doctors,the(laboratorians) and detecting infection department in hospital should markedly pay attention to drug-resistant(bacterium) detection,pathogen mutation and drug-resistance trend,in(order) to reasonably use antibacterial(agents).