我院近6年临床分离病原菌谱及耐药性的变化

目的了解临床分离病原菌种类分布及对抗菌药物耐药性的变化.方法回顾分析我院1998～2003年,从临床标本分离到的5 504株病原菌及耐药情况.结果革兰阴性菌比例为36.4%～60.1%呈下降趋势,革兰阳性菌为23.1%～47.6%呈上升趋势,其中铜绿假单胞菌及大肠埃希菌分别降至3.6%和9.3%,凝固酶阴性葡萄球菌及金黄色葡萄球菌分别升至35.2%及10.6%;葡萄球菌对抗菌药物耐药严重,仅万古霉素耐药率为0.0%,其次利福平＜46.1%;阴性菌对亚胺培南、哌拉西林/他唑巴坦及阿米卡星耐药率为1.8%～46.5%;真菌对两性霉素B耐药率＜7.7%.结论病原菌的构成及耐药性不断变化,与抗菌药物使用不当有关,加强耐药性监测,合理使用抗菌药物十分重要.

Variation of Clinical Bacterial Isolates and Antibiotic Resistance

OBJECTIVE To investigate the distribution of clinical bacterial isolates and the change in antibiotic (resistance) spectrum. METHODS A total of 5 504 strains from clinical samples in our hospital and their antibiotic (resistance) during 1998 to 2003 were studied retrospectively. RESULTS The amount of Gram-negative bacteria went down and of Gram-positive bacteria went up. Pseudomonas aeruginosa and Escherichia coli went down to 3.6% and 9.3%, coagulase-negative Staphylococcus and S. aureus went up to 35.2% and 10.6%, respectively. Drug resistance rates of Staphylococcus to vancomycin and rifampin were 0.0% and less than 46.1%, respectively. Gram-negative bacteria were poorly resistant to imipenem,piperacillin/tazobactam, amikacin (1.8-46.5%). Drug resistance rates to amphotericin B of yeasts were less than 7.7%. CONCLUSIONS The variation of drug resistance and distribution of clinical bacterial isolates are related to the improper use of antibiotics. It is very important to select antibiotics correctly according to the results of susceptibility tests.