医院病原菌耐药性变迁及对策

目的了解我院临床分离病原菌的耐药性变化，为我院制订对策和指导临床用药提供依据。方法将我院7年间临床分离病原菌药敏试验结果，应用WHONET软件进行统计学分析。结果从临床共分离到病原菌3027株，其中革兰氏阴性菌72％，革兰氏阳性菌占13％，真菌占15％。大肠埃希菌占医院病原菌的首位，其次为铜绿假单胞菌和白色念珠菌。除万古霉素对革兰氏阳性球菌和亚胺培南对革兰氏阴性杆菌耐药率很低外，其他所监测的抗菌药物均有不同程度的耐药。尤以产酶细菌的耐药性升高明显。结论细菌的耐药情况较严重，应采取切实有效的措施，减缓耐药菌的产生和蔓延。

Variation of drug resistance of pathogens and countermeasures in hospital

Objective To study drug resistance dynamics of clinical isolated bacteria and provide reference for clinical treat ment and infection control in our hospital. Methods Bacterial drug susceptibility of the clinical isolated were tested by Kirby - Bauer method and WHONETS. 3 software was applied to analyze the data. Results A total of 3 027 strains pathogens were isolated during the past 7 years. Among them, Gram - negative bacilli accounted for 72%, Gram - positive cocci for 13%, fungi for 15%. The main pathogens of them in clinical were Escherichia coli, Pseudomonas aeruginosa and Candidan albicans. The highest susceptible to Gram - positive was vancomycin and to Gram - negative was imipenern. The susceptibility of the other antibiotics decreased in various degree. The resistance rates of ESBLs - producing strains to most antibiotics were much higher than those of non - ESBLs - producing strains. Conclusion Drug resistance of the nosocomial infection bacterial is a serious problem. Prevalence of drug resistance bacteria should be effectively postponed by an appropriate methods including monitoring of resistant bacterial strains and rational utilization of antibiotics.