第二军医大学附属长征医院常见病原菌分布及耐药性分析

目的 分析第二军医大学附属长征医院2014年临床分离病原菌的细菌分布及耐药情况，为临床合理选用抗菌药物提供参考。方法 常规方法进行细菌培养，使用法国生物梅里埃公司VITEK-2全自动细菌分析仪进行病原菌鉴定及药敏分析，使用WHO NET 5.5软件进行数据统计处理。结果 G^-菌占78.09%；G⁺菌占21.91%。肺炎克雷伯杆菌检出率最高，为16.07%，较高的依次为大肠杆菌、鲍曼不动杆菌、铜绿假单胞菌，检出率分别为12.75%、12.69%、10.91%。耐甲氧西林金黄色葡萄球菌（MRSA）检出101株，检出率42.8%；耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）检出152株，检出率75.62%。金黄色葡萄球菌、凝固酶阴性葡萄球菌、粪肠球菌对万古霉素和利奈唑胺的耐药率均为0，屎肠球菌对万古霉素和利奈唑胺的耐药率分别为5.5%和0。急救科是病原菌的主要来源科室，主要病原菌在院内分布较广。结论 应高度重视细菌耐药情况，结合细菌谱及耐药性合理选用抗菌药物，减少耐药菌株的产生。

Distribution of common pathogens and resistance analysis in a tertiary hospital

Objective To analyse the distribution of main pathogens and drug resistance in a tertiary hospital during 2014, and to provide the reference for the clinical rational use of antimicrobial agents. Methods Conventional methods were used for bacterial culture, VITEK-2 automatic detection system of French BioMerieux company was used for bacteria identification, and bacterial resistance analysis, and WHO NET 5.5 software was used for data analysis. Results Gram negative bacteria accounted for 78.09%; Gram positive bacteria accounted for 21.91%. Klebsiella pneumoniae detection rate was the highest, that is 16.07%, followed by Escherichia Coli (12.75%), Bauman Acinetobacter (12.69%) and Pseudomonas aeruginosa (10.91%). The resistant rate of methicillin resistant Staphylococcus aureus(MRSA)was 42.8% (101), and the resistant rate of methicillin resistant coagulase negative staphylococci (MRCNS) was 75.62% (152). Resistant rates of Staphylococcus aureus, both coagulase negative staphylococcus and enterococcus faecalis to vancomycin and linezolid were zero. Resistant rates of enterococcus faecium to vancomycin and linezolid were 5.5% and zero respectively. Pathogens were detected mainly in emergency department, and the main pathogens were widely distributed. Conclusion Conducting monitoring of bacterial drug resistance and grasping the change trend of drug resistance have important significance to guide clinical rational drug use.