临床病原菌1828例分布及耐药分析

目的了解我院2006年至2007年临床感染病原菌分布及耐药情况，为临床治疗和合理用药提供参考依据。方法对临床送检的9895例标本共分离鉴定出1828株病原菌，对分离出病原菌进行药敏监测，同时进行大肠埃希菌、肺炎克雷伯氏菌的超广谱β-内酰胺酶（ESBLs）的检测及耐甲氧西林葡萄球菌（MRS）的测定。结果培养分离出1828株病原菌中，革兰阴性菌占58．7％，革兰阳性菌占28．6％，真菌占12．7％；病原茵居前5位分别是：大肠埃希菌20．5％，真菌12．69％，铜绿假单胞菌6．45％，肺炎克雷白杆菌6．45％，阴沟肠杆菌5．5％，真菌以白色念珠菌为主。大肠埃希菌及肺炎克雷白杆菌产酶率（ESBLs）为47．6％，耐甲氧西林葡萄球菌（MRS）占金葡菌的35．8％。结论细菌的多重耐药是我院目前面临的严重问题，临床用药应根据药敏试验结果选择抗生素，同时应加强抗生素的合理使用，控制细菌的耐药性。

Clinical pathogenic bacteria distribution and drug resistance of 1828 strains

Objective To determine the distribution of bacterial flora in hospital infection and to provide laboratory evidence for controlling hospital infection and selecting rationally antibiotics in clinic practice. Methods All isolates were identified by routine procedure. MRSA and ESBLS producing rate of escherichia coli and klebsiella pneumoniae were examined. Results Among all these clinical infections species, the most prevalent species were gram - negative bacteria with average positive detection of 58.7%. The second were grampositive bacteria （28.6%）. The third were fungi （12.7%） in average mainly were candid albicans. Escherichia coli 28.08% , fungi 12.69% , pseudomonas aeruginosa 9.24% , kleb-siella pneumoniae 7.54%, and ecloacae 6.31% took the first five bacteria in infection. The result of drug sensitivity rests showed that all of strains had higher resistance rate. The rate of extended - spectrum β-lactamases（ESBLS） was 47.6% and meticillin - resistant staphylococcus（MAS） was 42.3%. Conclusions Muhidrug resistance is the main risk factors in our hospital. During clinical therapy with antibiotics, we should select antibiotics according to the results of drug sensitivity tests and consider the spectrum of pathogenic species as well as the changes in the resistance thends of isolates. In order to reduce the production of drug resistance, the appropriate use of antibiotics must be strengthened.