临床分离菌细菌谱及耐药性分析

目的 了解病原菌分布及耐药性变迁，给疾病诊断和合理使用抗生素提供帮助。方法 对1999～2001年临床送检的各类标本，用Microscan A／S-4自动细菌鉴定及药敏测试仪进行鉴定和药敏试验并对其结果进行分析。结果 分离出病原菌45种，位居前10位的细菌依次是大肠杆菌、表皮葡萄球菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌、溶血性葡萄球菌、志贺氏菌、落菲不动杆菌、阴沟杆菌、鲍曼不动杆菌。葡萄球菌对青霉素、氨苄青霉素已普遍耐药，耐药率大于93％，革兰氏阳性球菌对亚胺培南、呋喃坦啶高度敏感，耐药率小于13％，对头孢唑啉、头孢呋肟、美洛培南敏感，耐药率小于30％。革兰氏阴性杆菌(落菲不动杆菌除外)对氨苄青霉素耐药率大于79％。结论 病原菌种类多，球杆菌比逐年下降。条件致病菌和人体正常菌分离率越来越高。头孢类药物耐药率存在第1代、第2代、第3代、第4代依次下降和逐年增加的趋势。阴沟杆菌等多种细菌多重耐药现象严重。

The analysis of spectrum and drug-resistance in bacteria by clinical separation

Objective To explore the distribution of pathogens and vicissitudes of drug resistance for offering the help about diagnosis and reasonable using antibiotics.Methods Microscan A/s 4 was used to identify the bacterium and the microbial sensitivity tests were used according clinical pathogens from 1999 to 2001.Results There were 45 classes of pathogens isolated,the anterior bacterium of positive rate were S.coli,S.epidermidis,K.pneumoniae,S.aureus,pseudomonas,S.haemolyticus,shigella,A.lwoffi,E.cliacae,A.baumanii in turn.S.aureus was widespreadly resisted to penicillin,ampicillin,the drug resistance rate was more than 93%.The opportunistic pathogens was gradually increased.Gram positive coccus very sensitized to imioenem,nitrofurantion,the drug resistance rate was under 13%;Gram positive coccus sensitized to cefazolin,ceftizoxime,meraopenem,the drug resistance rate was less than 30%.Drug resistance rate of Gram negative bacillus was morn than 79% with the exception of A.lwoffi.Conclusion There were plenty of pathogens isolated,and the ratio of coccus and bacillus was decreased year by year.The opportunistic pathogens and human normal floras gradually increased,the rate of drug resistance of the first,second,third,fourth cephalosporins decreased in turn.The multi-drug-resistance was serious such as E.cliacae etc.