某医院军人病房住院患者病原菌分布及耐药性分析

目的了解笔者所在医院军人病房住院患者感染的病原菌分布及耐药情况,指导临床用药,减少耐药的发生,为控制医院感染提供依据。方法对2012年01月—2012年12月军人病房送检的各类标本(痰、尿、血、分泌物、咽拭子、脓)进行培养,对病原菌进行分离、鉴定和药敏分析。结果分离出病原菌740株。以革兰阴性杆菌为主,分离出540株(73%),革兰阳性球菌105株(14.2%),真菌95株(12.8%)。检出率较高的病原菌依次为铜绿假单胞菌,肺炎克雷伯菌肺炎亚种,大肠埃希菌,鲍曼不动杆菌和金黄色葡萄球菌。各类标本中以痰中分离出的病原菌最多,革兰阴性杆菌对青霉素类和头孢菌素类药物的耐药性最高。革兰阳性球菌对青霉素类的耐药率最高,而常见的革兰阳性球菌对万古霉素敏感。结论细菌的耐药性呈现上升趋势,应继续加强病原菌耐药监测,指导患者合理用药。

Distribution and drug resistance of the pathogens isolated from the patients admitted armymen ward

Objective To determine the distribution and drug resistance of the pathogens isolated from admitted patients ,and provide reference for rational use of agents in clinics. Methods Bacteria were isolated from specimens included of sputum,urine,blood and secretion in patients from Jan. 2012 to Dec. 2012 in author＇s hospital,and relevant drug sensitivity tests were performed. Results A total of 740 strains were isolated,among them 540 strains were Gram-negative bacteria（73%）,Gram-positive cocci and fungus were 105 strains（14.2%） and 95 strains （12.8%）,respectively. The most common pathogens of them were Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii and Staphylococcus aureus. The Gram-negative bacteria varied in the drug resistance to antibiotics and many of them were resistant to the penicillins and cephalosporins. The Gram-positive cocci were susceptible to vancomycin,while most of them were resistant to the penicillins. Conclusion The drug resistance of bacteria is rising greatly. It is necessary to strengthen the surveillance of bacterial resistance and rational use of antimicrobial drugs.