外科系统院内感染菌谱及其抗生素的耐药性

目的：调查本院外科系统院内感染的菌群分布及其耐药状况，以指导临床用药。方法：采用VITEK-32 AMS System对外科2003～2004年临床标本进行细菌培养并检测其对多种抗生素的耐药性；采用WHONET 5软件进行统计和分析；根据1999年美国临床实验室标准委员会发布的标准判断细菌耐药性。结果：外科感染菌株共849株。其中凝固酶阴性葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、大肠埃希菌最常见。苯唑西林耐药金黄色葡萄球菌（MRSA）和苯唑西林耐药凝固酶阴性葡萄球菌（MRCNS）检出率分别为80．65％和87．73％；万古霉素耐药肠球菌（VRE）检出率为10．00％。亚胺培南、哌拉西林／他唑巴坦对革兰阴性杆菌的耐药率分别为0．00％～28．57％、5．61％～34．69％。结论：在外科系统开展细菌耐药性监测工作，随时掌握细菌耐药动态，对合理应用抗生素，提高现有抗生素的疗效，减缓耐药菌株发生发展的速度有重要意义。

Analysis of Antibiotics Resistance of Common Bacteria in Surgical System

Objective:To study the antibiotics resistance of common bacteria isolated from our hospitalized surgical patients from 2003 to 2004. Methods: The bacteria were identified with VITEK-32 automicrobiology system (AMS) and susceptibility tested. Laboratory data were analyzed by the statistic software of "WHONET-5" according to NCCLS publisned in 1999. Results: A total of 849 strains were isolated from 2003 to 2004. The common pathogens were coagulase negative Staphylococci(CNS), P.aeruginose, K.pneumoniae, S.aureus and E.cole.The detectable rates of Methicillin-resistant S.aureus(MRSA) and Methicillin-resistant coagulase negative Staphylococci(MRCNS) were 80.65% and 87.73%; The detectable rate of Vancomycin-Resistant Enterococci (VRE) was 10.00%.Imipenem and piperacillin-tazobactam showed the excellent activity against gram-negative bacteria . Conclusion:Antibiotic resistance should be seriously considered during surgical therapy and prohylaxis with antimicrobial agents, the surveillance of antibiotics resistance is important to improve the effect of antibiotics and to reduce the occurrence of antibiotics resistance of bacteria.