2007-2011年临床分离病原菌结构及其耐药性变迁

目的了解苏州市立医院本部近5年临床分离病原菌分布及其耐药性变迁。方法回顾性分析2007年1月—2011年12月临床分离病原菌资料。结果 5年间本院分离出的病原菌数目不断增加,以革兰阴性菌（55.1%）为主,革兰阳性菌（26.9%）和真菌（18.0%）次之。大肠埃希菌、白色假丝酵母菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌居检出菌的前五位。鲍曼不动杆菌每年呈快速增长之势,肠球菌属细菌感染近年也有明显增长,真菌构成比率偏高。耐甲氧西林葡萄球菌检出率在55.7%-79.1%。5年共分离到10株耐万古霉素肠球菌。肠杆菌科细菌中产ESBLs大肠埃希菌比率在50.2%-62.1%,肺炎克雷伯菌比率在42.3%-57.8%,首次分离到碳青霉烯类不敏感肠杆菌科细菌。耐碳青霉烯类铜绿假单胞菌比率在47.5%-60.9%。不动杆菌对多种抗菌药物的耐药性增长迅速,耐碳青霉烯类鲍曼不动杆菌比率逐年快速增长（11.9%-61.2%）。结论临床分离的病原菌构成比不断发生变化,鲍曼不动杆菌及肠球菌不断增多。多重耐药菌控制形势依然严峻。

Distribution and antimicrobial resistance variation of pathogenic bacteria isolated from clinical specimens from 2007 to 2011

Objective To investigate the pathogen distributions and antimicrobial resistance of bacteria isolated from clinical specimens in the municipal hospital of Suzhou for five consecutive years. Methods The date of pathogen identi- fication and susceptive test were retrospectivel analyzed from January 2007 to December 2011. Results A total number of mioroorganism isolated increased persistently. The gram- negative bacterium were the major pathogens, accounted for 55.1% ,the gram- positive bacterium and fungi accounted for 26.9% and 18.0%. The first five common strains were Escherichia coli, Candida albicans, Pseudomonas aeruginos, Klebsiella pneumoniae, Staphylococcus aureus. Acinetobacter baumannii and enterococci increased obviously,The fungi was detected highly. The prevalence of Methicillin resistant Staphylococcus （MRS） was 55.7 %-79.1%. 10 Strains resistant to vancomycin were detected in Enterococci. The prev- alence of ESBLs-producing E, coli was 50.2 %/00-62. 1%, K. pneumoniae was 42.3 %-57.8 %, Enterobacteriaceae strains non-susceptible to carbapenems were detected. The prevalence of carbapenems-resistant P. aeruginosa was 47.5 %-60. 9%. The prevalence of carbapenems-resistant A. baumannii increased quickly （11. 9%-61. 2%）. Conclusion The pathogen distributions has been changing all the time. A. baumanii and enterococci have become more and more in noso- comial infections. Multidrug resistant strains is still serious.