临床常见病原菌菌群变化与耐药分析

目的 研究医院病原菌菌群及耐药性分析。方法 对1996—2000年住院病人分离致病菌及其药敏结果，以每1年为一个阶段进行统计、对比分析。结果 5201株病原菌中革兰阴性菌占64．18％，革兰阳性菌占29、4％，真菌占6．42％。革兰阴性菌中，赐杆菌属逐年下降，而非发酵菌呈增长趋势；革兰阳性菌中，MRSA检出率较稳定，其它菌呈逐年下降趋势。大肠埃希菌、肺炎克雷伯菌对亚胺培南耐药性无明显变化，耐药率均低于5％，但对其它抗菌药物耐药性均逐年增加，其中产ESBL菌株检出率年平均增长速度为31．98％；铜绿假单胞菌、鲍曼不动杆菌对各类杭菌食耐药性在逐年增加，呈多重耐药；MRSA与MRCNS中未发现耐万古霉食株。结论 及时掌握病原菌及耐药性的动向，有利于指导临床合理选择抗菌药物。

Prevalence and drug resistance of clinical isolated bacteria

Objective To study the prevalence of pathogenic bacterial in inpatients and their resistance to antibiotics. Methods Analysis was made on clinical data of bacterial from 1996 to 2000 at every year interval:1996,1997,1998,1999 and 2000. Results Of 5201 strains of bacteria ,there were 64.18% gram negative bacilli ,29.4% gram positive bacilli and 6.42% fungus respectively.The number of genus Enterobacter decreased gradually.The number of other gram negative bacilli increase and positive bacilli decreased gradually respectively. The resistance rates of E.coli and P.klebsiella to imipenem did not change ,which was lower than 5% but their resistant rates to other antibiotics increase year by year. The increasing rates of ESBLs producing strains averaged 31.98% annually and multidrug resistance was apparently than other, that of P.aeruginosa was 25.21% and drug resistance and resistance rates were all above 45% to others. MRSA and MRCNS were high resistant to antibiotics tested, but all sensitive to vancomycin. Conclusion It is valuable to monitoring the spectrum of pathogenic bacteria and their drug resistance timely.