2010—2012年我院临床细菌分布及耐药性分析

目的：了解2010—2012年我院常见病原菌分布特点及对各种临床常用抗菌药物的耐药性,为临床合理使用抗菌药物提供参考。方法：统计和整理2010—2012年我院送检细菌培养标本中分离出的病原菌,并对其耐药性进行分析。结果：2010—2012年我院共分离出病原菌5 992株,其中革兰阳性菌13 94株,占23.26%;革兰阴性菌4 691株,占78.29%。革兰阳性菌中,金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌（MRSA）菌株平均占68.37%,表皮葡萄球菌中耐甲氧西林表皮葡萄球菌（MRSE）菌株平均占69.51%。革兰阴性菌中,肠杆菌科细菌以大肠埃希菌最多见,非发酵菌科以铜绿假单胞菌多见。肠杆菌科细菌中产超广谱β-内酰胺酶（ESBL）大肠埃希菌的检出率为64.5%;产ESBL肺炎克雷伯菌的检出率为47.3%。结论：院内感染以革兰阴性杆菌为主,细菌耐药性呈增长趋势,需加强耐药性监测,尤其是对产酶菌和多重耐药菌的监测,应采取有效的控制措施,为临床正确使用抗菌药物提供参考。

Distribution of Clinical Pathogens and Analysis of Drug Resistance in Our Hospital During 2010- 2012

OBJECTIVE：To investigate the characteristics of the distribution of common clinical pathogens in our hospital during 2010-2012 and their resistance to commonly used antibiotics for reference of clinical rational use of antibiotics in our hospital. METHODS： The pathogens isolated from the specimens sent for bacterial culture during 2010-2012 and their drug resistance were analyzed statistically. RESULTS： A total of 5 992 pathogen strains were isolated in our hospital during 2010-2012, of which, 1 394 （23.26%） were gram-positive strains and 4 691 （78.29%） gram-negative strains. Among the gram-positive strains, Methicillin resistant S. aureus （MRSA） strains represented an average of 68.37% of total Staphylococcus aureus strains, and methieillin-resistant Staphylococcus aureus （MRSA） strains accounted for an average of 68.37% of total Staphylococcus aureus, and methieillin-resistant Staphylococcus epidermidis Staphylococcus epidermidis （MRSE） strains accounted for an average 69.51% of total Staphylococcus epidermidis strains. Among the gram-negative strains, Escheriehia coli（ E. coli） were the most common strains in Enterobacteriaceae and Pseudomonas aeruginosa were more common among non-zymophytes. The detection rate of extended-spectrum beta-lactamases （ESBL） in Enterobacteriaceae E. coli was 64.5%. The detection rate of Klebsiella pneumoniae was 47.3%. CONCLUSION： Gram-negative bacilli took the lead in nosocomial infection, and the bacterial resistance showed a rising trend, thus it is important to take effective control measures to strengthen the monitoring of drug resistance, especially on the monitoring of enzyme-producing bacteria and multi- resistant bacteria so as to provide reference for clinical proper use of antibiotics.