临床感染病原菌的分布及耐药性监测

目的 研究临床感染病原菌的分布，揭示感染特征及流行病学规律，为感染性疾病的诊疗提供依据。方法对我院临床感染患者标本中分离的5514株病原菌进行鉴定，监测常见分离菌的耐药菌株(MDR)。结果5514株分离菌以G^-杆菌为主(56．5％)，其次为G^ 球菌(26．1％)和酵母样菌(16．6％)；分布占前十位的细菌为：凝固酶阴性的葡萄球菌、大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、金黄色葡萄球菌、阴沟肠杆菌、肠球菌、嗜麦芽窄食假单胞菌、肺炎链球菌。大肠埃希菌、肺炎克雷伯菌中产生广谱β-内酰胺酶(ESBLs)株分别是25．4％、20．5％。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的65．4％、78.8％，无万古霉素耐药株；氨基糖苷类高水平耐药(HLAR)肠球菌检出率为63．1％，耐万古霉素肠球菌(VRE)占5．8％。结论正常菌群、条件致病菌是现代医院感染的主要病原菌。耐药菌株的不断出现和对抗生素多重耐药是目前临床上的严重问题。临床上应合理使用抗生素。减少耐药菌株的产生及播散。

Distribution of pathogen and resistance surveillance in clinical infection

Objective To study the distribution of clinical infectious pathogen,to reveal infectious characteristics and epidemiology,and to provide basis for infectious disease diagnosis and therapy Methods 5514 strains of pathogen were identified,to survey multiple drug resistance(MDR)in main isolated bacteria Results Gram negative bacteria?Gram positive bacteria and saccharomyces were 56 5%?26 1%?16 6%,respectively The top 10 bacteria were coagulase negative staphylococcus?Escherichia coli?Pseudomonas aeruginosa?Klebsiella pneumoniae?Acinetobacter baumannii?Staphylococcus aureus?Enterobacter cloacae?Enterococcus?Xanthomonas maltophilia?Streptococcus pneumoniae The ESBLs strains producing accounted for 25 4% in E coli and 20 5% in K pneumoniae;MRSA and MRCNS accounted for 65 4% and 78 8% of S aureus and coagulase negative staphylococcus respectively,and no Vancomycin resistant strains were found HLAR produces of Enterococcus was 63 1%,and the Enterococcus resisting Vancomycin was 5 8% Conclusions The normal flora and to conditional pathogens were main strains in nosocomial infection MDR and new drug resistance strains are still or even a more serious problem than before We must use antibiotic reasonablly to reduce production and transmission of drug resistance strains