临床常见病原菌及其耐药性分析

目的了解某院2008～2010年间临床分离病原菌的分布及其耐药情况。方法用法国梅里埃VITEK32对2008～2010年期间该院分离到的病原菌进行鉴定,并用GPS、GNS及K-B纸片法做药物敏感性实验,其中GPS和GNS可对部分病原菌的产酶状况进行检测,药敏标准严格遵守CLSI进行判读。结果共收集到该院就诊患者送检标本3562份,共检测出1160例病原菌,总病原检出率为32.6%,病原检出率逐年上升。在这3年中,产β-内酰胺酶金黄色葡萄球菌分别占93.9%、91.7%和87.5%,有逐年下降趋势,但金黄色葡萄球菌对苯唑西林耐药率却从35.3%、36.1%上升到41.9%,产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯所占比例亦逐年增加,多重耐药铜绿假单胞菌在2008～2010年间各年所占比率分别为7.6%、12.9%和27.3%,亦呈上升趋势。结论在2008～2010年间,该院病原菌数量逐年增加,耐药率亦逐年上升,及时检测临床病原谱的变化及其耐药趋势以指导临床用药非常重要。

Analysis on the Clinical Familiar Pathogenic Distribution and Drug-resistant

OBJECTIVE To understand the clinical familiar pathogenic distribution and drug-resistant situations during 2008 to 2010.METHODS All pathogenic bacteria were identified by VITEK 32(bioMerieux,France),drug sensitivity test and enzyme was detected by GPS and GNS.K-B test was also used to some bacteria.RESULTS 3 562 samples from clinical patients were collected and 1 160 bacteria were identified.The total rate was 32.6% and the rate was rising year after year.During the past three years,β-lactamases-producing Staphylococcus aureus occurred 93.9%,91.7% and 87.5%,respectively,and a descendant trend was showed.But the numbers of oxazociliine-resistant Staphylococcus aureus were raising from 35.3% to 41.9%.ESBLs-producing Escherichia coli and Klebsiella pneumoniae were also increasing year after year.The rates of multidrug-resistant Pseudomonas aeruginosa of 2008 to 2010 were 7.6%,12.9% and 27.3%,respectively,and the trend still increased.CONCLUSION From 2008 to 2010,bacterial quantities were increasing year after year,and drug-resistant rates was raising year after year.It has important role for guide clinical applications of antibiotics to detect the changes of bacteria and their drug-resistant.