某院1682株病原菌分布及耐药性分析

目的 分析临床分离菌株,了解该院临床常见病原菌的种类及细菌耐药性,为临床抗菌剂的合理应用提供科学指导,为制定区域性院内感染防治提供依据.方法 收集2010～2011年住院及门诊患者各种标本,培养分离菌株采用K-B法标准,以CLSI 2009年版为判定标准进行药敏实验.其中,大肠埃希菌、肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)株的检测采用CLSI推荐的纸片筛选与表型确证实验;耐甲氧西林金黄色葡萄球菌(MRSA)的检测采用头孢西丁纸片作K-B法确认,应用WHONET5.4软件进行数据处理和分析.结果 1 682株临床分离菌株中革兰阴性菌占65.93%,革兰阳性菌占29.96%,真菌占4.10%.分离出大肠埃希菌产ESBLs 366株,肺炎克雷伯菌产ESBLs 99株,耐甲氧西林金黄色葡萄球菌(MRSA)144株.结论 该院临床致病菌主要为革兰阴性菌,产酶菌株的检出率较低.加强细菌的耐药性监测,指导临床选择敏感性强的药物,减缓细菌的耐药性意义重大.

Distribution and drug resistance of 1 682 strains of pathogenic bacteria in one hospital

Objective To analyze the clinical isolates and investigate the types of commonly encountered clinical pathogens and their drug resistance in this hospital,and to provide scientific guidance for reasonable choices of clinical antibiotics and provide the basis for the formulation for the prophylaxis and control of regional nosocomial infection.Methods Variety of specimens were collected from inpatients and outpatients from 2010 to 2011.The K-B method was used to test the sensitivity of the specimens according to the CLSI criteria(2009 version).Extended-spectrum β-lactamase(ESBLs) in Escherichia coli and Klebsiella pneumonia were detected by the double-disk test and phenotypic confirmatory test,as recommendation of CLSI.Methicillin resistant Staphylococcus aureus(MRSA) was detected by K-B method using Cefoxitin disk,and the data was processed and analyzed by WHONET5.4 software.Results As the bacteria distribution in the 1 682 strains of clinical isolates,the main pathogenic bacteria were Gram-negative bacteria(65.93%),followed by Gram-positive bacteria(29.96%) and fungi(4.01%).366 strains of Escherichia coli and 66 strains of Klebsiella pneumonia were positive with the production of ESBLs,and 144 strains of MRSA were isolated.Conclusion The main clinical pathogens in this hospital might be Gram-negative bacteria,and the detection rate of strains producing the enzyme might be lower.Enhancing monitoring on the pathogenic drug resistance analysis could benefit the guide of clinical selection of sensitive drug and slow down the bacterial resistance to antibiotics.