2012年度某院患者无菌体液耐药性监测的调查

目的 了解2012年度该院患者无菌体液的细菌分布和对抗菌药物的耐药性.方法 对临床送检的无菌体液标本按常规进行病原菌分离,采用Vitek2-Compact系统和ATB Express系统进行鉴定,测定抗菌药物的最低抑菌浓度（MIC）值,采用纸片扩散法（K-B）进行微生物敏感性试验.应用WHONET 5.6软件进行数据分析.结果 分离菌株556株,革兰阴性菌316株（57%）,革兰阳性菌226株（40%）.常见细菌分别为大肠埃希菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌、粪肠球菌、屎肠球菌、鲍曼不动杆菌、铜绿假单胞菌.大肠埃希菌、肺炎克雷伯菌的检出率分别为53.3%和21.1%;检出9株金黄色葡萄球菌,其中,耐甲氧西林金黄色葡萄球菌（66%）;耐甲氧西林凝固酶阴性葡萄球菌（74%）.未发现对万古霉素和利奈唑胺耐药的葡萄球菌.未发现对万古霉素耐药的肠球菌属细菌.大肠埃希菌、肺炎克雷伯菌对碳青酶烯类耐药的检出率分别为3.8%和3.8%.结论 及时监测病原菌的菌群种类、分布和耐药变迁以指导临床合理、规范地使用抗菌药物.

Annual surveillance of drug resistance of sterile body fluids of patients in a certain hospital in 2012

Objective To learn the bacterial distribution of sterile body fluids of patients and the antimicrobial resistance in a certain hospital in 2012. Methods Pathogens were isolated conventionally from clinical sterile body fluids specimens and were iden tilled by Vitek2-Compact system and the ATB Express systems. Minimal inhibitory concentrations （MICs） method and Kirby- Bauer（K B） method were employed to conduct the microbial sensitivity test. Data analysis was performed with WHONET 5. 6 software . Results Results 556 bacterial strains were isolated with 316（57%） of gram-negative and 226（40%） of gram-positive. The most common bacteria were Escherichia coli, coagulase-negative staphylococci, Klebsiella pneurnoniae, Enterococcus f aeca lis , Enterococcus feces, Acinetobacter baumannii , Pseudornonas aeruginosa , respectively. The detection rates of Escherichia coli , Klebsiella pneumoniae were 53.3 % and 21.1 %, respectively. Nine strains of Staphylococcus aureus were detected, including methicillin-resistant Staphylococcus aureus （66 %） and methicillin-resistant coagulase-negative staphylococci（ 74 % ）. No vancomycin- resistant Staphylococcus aureus and linezolid-resistant Staphylococcus aureus were detected. And no vancomycin-resistant Enterococcus bacteria were found, either. The detection rates of carbapenem resistant Escherichia coli and Klebsiella pneumoniae were 3.8 % and 3.8 %, respectively. Conclusion Pathogenic flora species, distribution and changes in antibiotics resistantance should be monitored timely to guide clinical use of antimicrobial drugs rationally and standardly.