院内感染病原菌分布及主要革兰氏阴性杆菌的耐药性分析

目的分析我院2011年与2012年院内感染病原菌的分布及主要革兰氏阴性杆菌的耐药性，以便掌握院内感染的控制情况．为临床合理使用抗菌药物提供科学的依据。方法两年的分离菌应用法国生物梅里埃公司生产ATB—Expression半自动微生物分析／药敏系统及配套的细菌鉴定卡和药敏卡进行测定；部分手工药敏试验采用纸片扩散法，并进行耐药性分析。结果2011年全院总标本量22177份，标本阳性数为5601例，检出率为25．3％，2012年全院总标本量22020份。标本阳性数为6614例，检出率为30．0％。两年检出量排名前6位的微生物均为大肠埃希菌、白假丝酵母、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌。2012年我院分离的鲍曼不动杆菌，其耐药率比上一年明显上升，对阿米卡星、头孢他定、头孢吡肟的耐药率分别由2011年的32.4％、33．1％、36．0％上升到2012年的43．1％、46．0％、45．7％，对亚胺培南、美罗培南、替卡西林、替卡西林／棒酸和哌拉西林／他唑巴坦的耐药率，分别由2011年的33．5％、32．9％、43.3％、39．9％和41．1％上升到2012年的44．9％、44．4％、46．6％、49．8％和47．8％。结论鲍曼不动杆菌对氨基糖甙类、碳氢霉烯类和头孢类药物的耐药率比上一年呈明显上升趋势，大肠埃希菌和肺炎克雷伯菌对碳氢霉烯类的耐药率比上一年明显升高。

Investigate distribution characteristics of pathogenic bacteria in the hospital and drug resistant analysis of major Gram-Negative bacillus

Objective To investigate distribution characteristics of pathogenic bacteria in the hospital and drug resistant analysis of major Gram-Negative bacillus between 2011 and 2012. Methods All strains separated from our hospital during 2011 and 2012, were identified and susceptibility using the ATB- Expression. And some drug sensitive tests were adopted scrip diffusion method. Results The 5 601 of 22 177（25.3%） samples were positive in 2011. The 6 614 of 22 020 （30.0%） samples were positive in 2012. Eseherichia coli, Monilia albicans, Pseudomonas aeruginosa, Klebsiella pneumonia, Staphylococcus aureus ancl Aeinetobacter baumannii ranked ahead sixth of pathogenic bacteria in the hospital. Drug resistant rate of Acinetobacter bau- mannii increased obviously in 2012 than that in 2011. The rates of antibiotics of Amikacin, Cefiazidime and Ccfepime were 32.4% ,33.1% ,36.0% respectively in 2011, rised up to about 43.1% ,46.0% and 45.7% in 2012. The rates of Antibiotics of Imipenem, Meropenem, Ticarcillin, Ticarcillin/clavulanic acid and Piperacillin]Tazobactam were 33.5% ,32.9% ,43.3% ,39.9% and 41.1% respectively in 2011, rised up to 44.9% ,44.4% ,46.6% ,49.8% and 47.8% in 2012. Conclusion The rates of aminoglycosides, carbopenems and cephalosporins resistance in Acinetobacter baumannii in 2012 increased obviously than those in 2011. The rates of carbopenems in Escherichia coli and klebsiella pneumonia in 2012 increased obviously than those in 2011 too.