2012年北京市海淀医院156例血流感染病原学及耐药性分析

目的：统计北京市海淀医院2012年度血流感染病原菌分布和细菌耐药情况。方法对北京市海淀医院2012年1月1日至2012年12月31日收集的血标本进行细菌、真菌分离培养及鉴定，用WHO-NET 5.6软件以及SPSS 12.0进行描述性统计分析。结果北京市海淀医院2012年度共分离病原菌156株，其中，革兰阳性菌株70株（44.9%），革兰阴性菌株83株（53.2%）。常见细菌依次为大肠埃希菌32.1%（50/156）、凝固酶阴性葡萄球菌28.8%（45/156）、肺炎克雷伯菌9.0%（14/156）和金黄色葡萄球菌6.4%（10/156）。葡萄球菌中耐甲氧西林金黄色葡萄球菌占9.1%（10/55），凝固酶阴性葡萄球菌占81.8%（45/55）。大肠埃希菌和肺炎克雷伯菌对青霉素、第1、2代头孢菌素耐药率较高，为38%～85%。对喹诺酮类药物，大肠埃希菌耐药率50%～60%，肺炎克雷伯菌耐药率为15%～30%。葡萄球菌对β-内酰胺类、大环内酯类、氨基糖苷类和喹诺酮类等抗菌药的总体耐药率为30%～86%，未发现对万古霉素及利奈唑胺耐药菌株。结论2012年度血培养分离细菌耐药是普遍现象，应加强细菌性耐药性监测，为临床合理规范使用抗菌药物提供参考。

Bacterial distribution and drug resistance in bloodstream infection of 2012 in Beijing Haidian Hospital

Objective To investigate the bacterial distribution and drug resistance in bloodstream infection.Methods All of the bacterial susceptibility results from January 1st to December 31st, 2012 in Beijing Haidian Hospital were collected by unified protocol and the data were analyzed by software WHONET 5.6 and SPSS12.0.Results Total of 156 isolates and their antibacterial susceptibility data were collected,which included 83 （53.2%） gram-negative bacterial strains and 70 （44.9%） gram-positive bacterial strains.Escherichia coli（50/156, 32.1%）, Coagulase negativeStaphylococcus （45/156, 28.8%）,Klebsiella pneumoniae （14/156, 9.0%）,Staphylococcus aureus （10/156, 6.4%） were the most common isolates. The incidences of meticillin-resistantStaphylococcus aureus （MRSA） and coagulase negativeStaphylococcus （MRSCN） were 9.1% and 81.8%, respectively. The resistance rates ofEscherichia coli andKlebsiella pneumoniae to penicillin and 1 or 2 generation cephamycins were 38%-85%. The resistance rates of Escherichia coli andKlebsiella pneumoniae to quinolinones were 50%-60% and 15%-30%, respectively. No vancomycin and linezolid resistantStaphylococcus strains were found.Conclusions Bacterial resistance was common according to this report, thus we should enhance bacterial resistance monitoring for clinical rational use of antimicrobial agents.