2011～2015年医院分离细菌耐药性分析

目的：分析2011～2015年本院临床分离病原菌的构成及耐药性，为临床医师选择抗菌药物提供参考。方法收集5年内本院各类标本中分离出的主要病原菌，对其耐药性进行分析。结果共收集非重复的细菌3817株。其中革兰阴性菌占72．9％，革兰阳性菌占27．1％。分离的肠杆菌科细菌对碳青霉烯类抗菌药物的耐药率普遍很低（＜10％），因此，碳青霉烯类抗菌药物仍然是治疗肠杆菌科细菌感染的首选药物。大肠埃希菌和肺炎克雷伯菌产ESBLs菌株检出率相对稳定，分别波动于46．6～54．4％和36．5～41．1％之间。非发酵菌中，多重耐药铜绿假单胞菌和碳青霉烯类耐药鲍曼不动杆菌检出率逐年增高。革兰阳性菌不同菌种的耐药谱明显不同，未发现对万古霉素、替考拉宁和利奈唑胺耐药的菌株。结论本院分离出的病原菌以革兰阴性菌为主，多重耐药菌逐年增多。临床医师应及时掌握本院病原菌分布及耐药性最新动态，合理使用抗菌药物。

Analysis of antibiotic resistance of clinical isolated bacteria from 2011to 2015

Objective To analyze the distribution and drug resistance of main bacteria isolated from Jan 1st 2011 to Dec 31st 2015 ,so as to provide a reference for clinicians to choose antimicrobial agents .Methods Collect main pathogens isolated from all kinds of specimens in our hospital in the past five years ,and analyze its drug resistance .Results A total of 3817 strains that have no duplicates were isolated in clinical during the five years ,which included 72 .9 % Gram‐negative bacteria and 27 .1 % Gram‐posi‐tive bacteria .The drug resistance rate of Enterobacteriaceae bacteria for carbapenems is generally very low (<10% ) ,so carbapene‐ms antimicrobial agents is still the first choice drug for the treatment of Enterobacteriaceae bacteria infection .The rate of E .coli and K .pneumoniae producing extended spectrum beta‐lactamase(ESBLs)strains is relatively stable ,their rates are volatility between 46 . 6 to 54 .4% and 36 .5 to 41 .1% .In Nonfermenters ,The separated rate of Multi‐drug resistant pseudomonas aeruginosa and carbap‐enem‐resistance Acinetobacter baumanii were increased year by year .The drug resistant spectrums of gram‐positive bacteria were different .No strains resistant to vancomycin ,teicoplanin and linezolid were found .Conclusion The pathogenic bacterias that We i‐solated mainly are Gram‐negative bacterias ,the multiple drug‐resistant bacteria increased year by year .Clinicians should know the latest trends of the pathogens and drug resistance ,and use the antimicrobial agents reasonably .