2013-2015年徐州市第一人民医院病原菌的分布和耐药性分析

目的 分析2013—2015年徐州市第一人民医院病原菌的分布和耐药性分析.方法 回顾性分析2013年1月—2015年12月于徐州市第一人民医院进行住院治疗患者的临床资料,探讨病原菌分布特点和细菌耐药情况.结果 医院感染病原菌标本来源主要为痰液、尿液、血液,分别占55.0%、17.6%、10.6%.2013—2015年共分离病原菌菌株3106株,其中革兰阴性菌占63.1%,革兰阳性菌占21.2%,真菌占15.7%;各年度病原菌分布均以革兰阴性菌为主,主要以大肠埃希菌(18.1%)、鲍曼不动杆菌(14.0%)、铜绿假单胞菌(13.2%)、肺炎克雷伯菌(9.7%)为主.大肠埃希菌、肺炎克雷伯菌均对氨苄西林、哌拉西林耐药严重,对阿米卡星、哌拉西林/他唑巴坦、美洛培南、亚胺培南、头孢哌酮/舒巴坦敏感;鲍曼不动杆菌对阿莫西林/克拉维酸、氨苄西林、氨曲南耐药、哌拉西林耐药严重,对头孢哌酮/舒巴坦敏感;铜绿假单胞菌对阿莫西林/克拉维酸、氨苄西林、氨苄西林/舒巴坦、复方新诺明、头孢噻肟耐药严重,对阿米卡星、头孢哌酮/舒巴坦敏感.革兰阳性菌主要以金黄葡萄球菌(10.4%)为主,对氨苄西林、克林霉素、青霉素、红霉素耐药严重,对喹奴普汀/达夫普汀、吗啉(恶)酮、替考拉宁、万古霉素敏感.结论 2013—2015年徐州市第一人民医院病原菌主要以革兰阴性菌为主,耐药情况比较普遍,需根据药敏试验结果合理用药,减少医院感染.

Analysis on distribution and drug resistance of pathogenic bacteria in the First People's Hospital of Xuzhou from 2013 to 2015

Objective To investigate the distribution and drug resistance of pathogenic bacteria in the First People''s Hospital of Xuzhou from 2013 to 2015. Methods A retrospective analysis from January 2013 to December 2015 in the First People''s Hospital of Xuzhou were collected on the clinical data of patients with nosocomial infection, and the distribution and drug resistance of pathogenic bacteria were investigated. Results The pathogens of nosocomial infection were mainly isolated from sputum, urine, blood, accounted for 55.0%, 17.6%, and 10.6%, respectively. A total of 3 106 strains of pathogenic bacteria were isolated from 2013 to 2015, including Gram-negative bacteria (63.1%), Gram positive bacteria (21.2%), and fungi (15.7%). Gram negative bacteria were mainly Escherichia coli (18.1%), Acinetobacter baumanniis (14.0%), Klebsiella pneumoniae (13.2%), and Pseudomonas aeruginosa (9.7%). E. coli and K. pneumoniae were seriously resistant to ampicillin and piperacillin, and sensitive to amikacin, piperacillin/tazobactam, meropenem, imipenem, and cefoperazone/sulbactam. A. baumanniis were seriously resistant to amoxicillin/clavulanic acid, ampicillin, aztreonam and piperacillin, and sensitive to amikacin, cefoperazone/sulbactam. Gram positive bacteria were mainly Staphylococcus aureus (10.4%), which were seriously resistant to ampicillin, penicillin, erythromycin, clindamycin, and sensitive to quinupristin/dave leptin, teicoplanin, vancomycin, and linezolid. Conclusion The pathogenic bacteria in the First People''s Hospital of Xuzhou from 2013 to 2015 are mainly Gram negative bacteria, and the drug resistance is more common, so it is necessary to use the drug in accordance with the results of drug sensitivity test, and reduce hospital infection.