临床病原菌的耐药性研究

目的:研究我院住院患者中分离的病原菌的耐药状况。方法:将2005年1月至2006年12月住院患者的血液、尿液、痰、生殖道分泌物、粪便以及伤口分泌物标本中分离的病原菌进行药敏试验和耐药率分析。结果:分离菌株主要为大肠埃希菌(17.6%)、肺炎克雷伯菌(16.1%)、铜绿假单胞菌(23.5%)、鲍曼不动杆菌(12.8%)、阴沟肠杆菌(19.8%)和金黄色葡萄球菌(10.2%)。产广谱β-内酰胺酶(ESBL)菌在肺炎克雷伯菌和大肠埃希菌中的检出率为41.3%。革兰阴性菌对哌拉西林/他唑巴坦、亚胺培南和美罗培南较为敏感,金黄色葡萄球菌对头孢菌素的耐药率超过70%。产ESBL菌对21种常用抗菌药的平均耐药率为74.1%。病原菌的检出率如下:产ESBL菌41.3%,金黄色葡萄球菌10.2%,耐苯唑西林金黄色葡萄球菌49.0%。未检出耐万古霉素葡萄球菌。结论:产ESBL菌和耐苯唑西林金黄色葡萄球菌有多重耐药性。病原菌分离株的药敏试验对临床选用有效抗菌药及其合理应用颇为重要。

Investigation on drug resistance of clinical pathogenic microorganisms

Objective:To investigate the drug resistance of pathogenic microorganisms from the in-patients in our hospital.Methods:The pathogenic microorganisms were isolated from in-patients' samples of blood,urine,sputum,genital tract secretion,feces,and wound secretion between January 2005 and December 2006.The antibacterial sensitivity testing of isolated bacterial strains was performed and their resistance rate was analyzed.Results:The predominant isolates were Escherichia coli(17.6%),Klebsiella pneumonia(16.1%),Pseudomonas aeruginos(23.5%),Acinetobacter baumannii(12.8%),Enterobacter cloacae(19.8%),and Staphylococcus aureus(10.2%).The detect rate of ESBL-producing isolates,from Klebsiella pneumonia and Escherichia coli was 41.3%.Gram-negative bacteria were susceptible to piperacillin sodium/tazobactam sodium,imipenem,and meropenem.The resistance rate of Staphylococcus aureus to cephalosporins was >70%.The average resistance rate of ESBL-producing organisms to 21 commonly used antibacterial agents was 74.1%.The detection rates of pathogenic microorganisms was as follows:ESBL-producing organisms 41.3%,Staphylococcus aureus 10.2%,oxacillin-resistant Staphylococcus aureus 49.0%.Vancomycin-resistant Staphylococcus was undetected.Conclusion:ESBL-producing organisms and oxacillin-resistant Staphylococcus aureus have multi-resistance.And antibacterial sensitivity testing of isolated bacterial strains is important in the selection of effective antibacterial agents and their rational use for clinical therapy.