我院近3年的病原菌分布与耐药情况分析

目的调查我院3年来病原菌的分布及耐药趋势,为临床用药提供科学依据。方法对2004年11月—2007年9月全院门诊住院患者各类标本中分离出来的病原菌及药敏分析,采用黑马生物鉴定系统进行。结果共分离病原菌1 630株,革兰阳性球菌515株（31.6%）,以金黄色葡萄球菌为主,其中耐甲氧西林葡萄球菌和凝固酶阴性葡萄球菌为65.1%和79.3%,未发现耐万古霉素菌株;革兰阴性杆菌1 106株,以大肠埃希菌（27.8%）,铜绿假单胞菌（19.1%）,肺炎克雷伯菌（10.3%）,溶血不动杆菌（9.1%）为主。革兰阴性杆菌对碳青霉烯类耐药率最低,其次是哌拉西林-他唑巴坦,头孢哌酮-舒巴坦,阿莫西林-棒酸,呋喃妥因,阿米卡星,头孢吡肟,但对部分抗菌药物产生多重耐药。结论医院内病原菌的分布有扩展的趋势且耐药率有上升的趋势,要加强对医务人员合理化使用抗菌药物的培训,加强细菌耐药的监测,加强对临床用药的督导,指导临床合理应用抗菌药物。

Analysis of Distribution and Antibacterial Resistance of Nosocomial Infection Pathogens in Our Hospital in Last Three Years

Objective To investigate the tendency of bacterial distribution and drug resistance of hospital infections in the last three years in order to provide a scientific evidence for the clinical treatment in the hospital. Methods Bacteria isolated from the patients in our hospital from Nov 2004 to Sep 2007 were identified by an identification system （BACT-IST）. Results Totally, 1,630 strains of pathogens were isolated, among which 515 strains were Gram-positive cocci （ 31.6% ） consisting mainlY of staphylococci aureus （ S. aureus ）. Out of the 5 i5 strains, meticillm-resistant strains accounted for 65.1% and coagulase-negative strains for 79.3 %. No vancomycin-resistant S. aureus were isolated from the samples. There were 1,106 strains of gram-negative bacteria, mainly including escherichia coli （27.8%）, pseudomonas aeruginosa （ 19.1% ）, klebsiella pneumoniae （ 10.3% ） and acinetobacter haemolyticus （9.1% ）. Gram-negative bacilli were the lowest resistant to carbapenems, and then to piperacillin/tazobactam （TZP）, cefoperazone/sulbactam （CFS）, amoxicillin/clavulanic acid （AMC）, furadantin （FD）, amikacin and cefepime, but they were multi-resistant to some antibiotics. Conclusion In hospital, the distribution of pathogens and the drug resistance have a tendency of expansion. Thus, in order to apply antibacterial drugs more reasonably, we should enhance the training of medical workers in the control of drug resistance, as well as the supervision of clinical treatment.