临床分离细菌耐药性及药物应用分析

目的了解我院2011年临床分离菌的分布和耐药特征,指导临床合理使用抗菌药物。方法采用纸片扩散法进行抗菌药物敏感性试验,并对肠杆菌科细菌进行ESBLs检测,按CLSI 2009年标准判定药敏结果,用WHONET5.4软件进行数据分析。结果 2011年我院共分离细菌351株,其中革兰阴性杆菌268株,占76.4%,革兰阳性球菌83株,占23.6%。金黄色葡萄球菌和大肠埃希菌分别是革兰阳性球菌和革兰阴性杆菌的第一位。大肠埃希菌和肺炎克雷伯菌中ESBLs的检出率分别为58.5%和46.2%。葡萄球菌属中MRSA和MRCNS的检出率分别为76.5%和83.9%。结论从我院患者分离的细菌耐药性比较严重,应该加强监测,指导临床合理使用抗菌药物。

Separation of clinical drug resistance of bacteria and analysis of the drug application

Objective To investigate the distribution and antibiotic resistance profile of common clinical isolates in Shenzhen Wujing Hospital during 2011. Methods Kirby-Bauer method was used to conduct susceptibility testing and ESBLs detection. The results were analyzed by WHONET 5.4 software according to CLSI 2009. Results Of the 351 clinical isolates, 76.4%（268/351） were gram-negative bacilli and 23.6% （83/351） were gram-positive cocci. S. aureus was the most common pathogen in gram-positive cocci. E. coli was the most frequently isolated pathogen in gram-nega- tive bacilli. ESBLs-producing strains were produced in 58.5% of E. coli and 46.2% of K. pneumoniae isolates respec- tively. Almost 76.5% of S. aureus isolates were MRSA, 83.9% of coagulase negative Staphylococcus isolates were me- thicillin-resistant. Conclusions Antimicrobial resistance in clinical bacterial isolates is a very serious problem in Wujing Hospital. Antimicrobial agents should be used rationally based on the results of susceptibility testing.