医院病原菌分布特征及耐药谱的研究

目的 :了解医院病原菌分布情况及耐药趋势 ,为临床用药和控制医院内感染提供科学依据。方法 :统计分析2 0 0 3年 1月至 1 2月间医院病原菌的分离结果及药敏试验结果。结果 :1 1 2 8株 (6 0种 )病原菌中 ,真菌 4 5 3株 ,占 4 0 .1 6 %;革兰阴性菌 4 2 7株 ,占 37.85 %;革兰阳性菌 2 4 8株 ,占 2 1 .99%.医院病原菌依次为白色念珠菌、大肠埃希菌、溶血葡萄球菌、铜绿假单胞菌、表皮葡萄球菌及热带念珠菌等。药敏试验结果显示 ,革兰阳性菌存在广泛耐药性 ,其首选药为万古霉素 ;革兰阴性菌对第 3代头孢菌素的耐药率已在 5 0 %左右 ,有的甚至高达 90 %以上 ,治疗革兰阴性菌感染的首选药为舒普深 ;真菌对益康唑和酮康唑也产生了一定的耐药性 ,其首选药物为制霉菌素和咪康唑。结论 :医院病原菌以真菌为主 ,以白色念珠菌多见。病原菌耐药性广泛 ,临床上应在药敏指导下合理使用抗生素 ,以减少耐药菌株的产生和降低院内感染。

A study on distribution and resistant-spectrum about pathogenic bacteria in hospital

Objective:To investigate the distribution of pathogenic bacteria in hospital and the trend of its resistance to antibiotic,providing the scientific evidence for clinical medicine and controlling the nosocomial infection.Methods:The result of susceptibility testing and the isolation of pathogenic bacteria from January to December in 2003 were analyzed.Results:Among 1128 strains(60 species )pathogenic bacteria,there are 453 strains fungi,which reaches 40.16%;427 strains gram-negative bacteria,which reaches 37.85% and 248 strains gram-positive bacteria,which reaches 21.99%.In proper order,pathogenic bacteria in hospital are including Candida albicans,Escherichia coli,Staphylococcus haemolyticus,Pseudomonas aeruginosa,Staphylococcus epidermidis,Candida tropicalis and so on,The result of susceptibility testing shows that gram-positive bacteria has a wide-ranging resistance to antibiotic and Vancomycin is the best drug for it;Gram-negative bacteria has an around 50% resistance rate to the third-generation Cephalosporins,some even over 90%and Sulperazon is the best drug for the infection caused by it.The fungi also produce certain resistance to Econazole and Ketoconazole,while Nystatin and Miconzole can take effect to it.Conclusion:Pathogenic bacteria in hospital are mainly fungi,especially Candida albicans.For the wide resistance of pathogenic bacteria to antibiotic,the antibiotic should be used properly according to susceptibility testing in order to reduce the production of resistance bacteria strains and mosocomial infection.