2014年某医院7 415例痰培养病原菌分布及药敏分析

目的 :调查2014年某医院下呼吸道标本首次检出的7 415株细菌的类型、科室分布及耐药情况,以指导临床合理用药。方法:应用WHONET5.6软件对7 415株细菌进行细菌分布、科室分布和耐药情况分析。结果:7 415株细菌前10位以革兰阴性杆菌为主,占总数的80.2%,其中检出率前3位的是铜绿假单胞菌(25.9%),鲍曼不动杆菌(20.5%),肺炎克雷伯菌(18.3%);革兰阳性菌占总数7.9%,其中金黄色葡萄球菌的检出率最高,占6.6%。病原菌的科室分布以急诊ICU最多(29.6%),其次为神经内科(19.2%),神经外科(17.2%)。大肠埃希菌对头孢唑林、头孢噻肟、头孢吡肟、环丙沙星、左旋氧氟沙星、莫西沙星、复方新诺明、四环素的耐药率均较高,在73.0%以上,肺炎克雷伯菌和铜绿假单胞菌对氨苄西林、阿莫西林/克拉维酸、氨苄西林/舒巴坦、头孢唑啉、头孢噻肟、环丙沙星、左旋氧氟沙星、莫西沙星、的耐药率较高,耐药率均已超过60.0%。大肠埃希菌与铜绿假单胞菌对碳青霉烯类药物的耐药率都在50%以下,金黄色葡萄球菌对苯唑西林的耐药率为75.4%,而对万古霉素的敏感率则为100%。结论:下呼吸道标本检出菌多集中在重症医学科,多为高水平的多重耐药菌。应当规范抗菌药物的使用,严格各种无菌操作技术,控制多重耐药菌的流行与传播。

Pathogenic bacteria distribution and drug sensitivity analysis of 7 415 sputum culture results in a teaching hospital of in 2014

Objective:To investigate the type, distribution and drug resistance of 7 415 strains of bacteria in the lower respiratory tract of a teaching hospital in 2014, and to guide clinical rational drug use. Methods: The distribution of bacteria, the distribution and drug resistance of 7 415 strains of bacteria were analyzed by WHONET5.6 software. Results: The top 10 bacteria of 7 415 strains were gram negative bacilli, which accounted for 80.2% of the total. Among them, Pseudomonas aeruginosa (25.9%), Bauman Acinetobacter (20.5%), Klebsiella pneumoniae (18.3%) were with the top 3 positive rate. Gram-positive bacteria accounted for 7.9%, and the detection rate of Staphylococcus aureus was the highest, accounting for 6.6%. The number of pathogenic bacteria was highest in ICU (29.6%), followed by the Department of internal medicine (19.2%), Department of Neurosurgery (17.2%). The resistance rates of E. coli on cefazolin, cefotaxime, cefepime, ciprofloxacin and ofloxacin, moxifloxacin, trimethoprim-sulfamethoxazole, and tetracycline were both higher with more than 73.0%. The resistance rates of Klebsiella pneumoniae and Pseudomonas aeruginosa on ampicillin, amoxicillin/clavulanic acid, ampicillin/shu ba jotham, cefazolin, cefotaxime, ciprofloxacin and ofloxacin, and moxifloxacin were both higher with more than 60.0%. The resistance rates of E. coli and Pseudomonas aeruginosa on carbon penicillium alkene were below 50%. The resistance rate of Staphylococcus aureus on benzene Westwood was 75.4%, and its sensitive rate on vancomycin was 100%. Conclusion: Gram-negative bacilli take a major position in respiratory system infection. Having higher resistance to commonly used antibiotics, sensitive antimicrobial drug should be chosen for clinical medicine, and the abuse of antibiotics should be avoided.