2005年至2010年临床常见病原菌的回顾性分析

目的:通过回顾性统计分析2005年至2010年分离出的临床常见病原菌种类及其构成比的变化和病区分布特征,为临床感染控制和临床医生经验用药提供实验室依据。方法:收集2005年至2010年我院临床送检标本分离的病原菌资料,动态比较分析病原菌构成比的变化和病区分布特征。结果:6年分离病原菌共11 733株,其中细菌9 257株,占78.90%,位居前8位的分别是大肠埃希菌(12.15%)、金黄色葡萄球菌(8.48%)、铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯氏菌、阴沟肠杆菌、溶血葡萄球菌、表皮葡萄球菌。其中大肠埃希菌产超广谱β-内酰胺酶(ESBLs)株占37.10%,耐甲氧西林的金黄色葡萄球菌(MRSA)占81.81%,肺炎克雷伯氏菌产ESBLs株占32.14%;铜绿假单胞菌的分离率呈波动性变化,泛耐药铜绿假单胞菌(PDRP)占19.55%;鲍曼不动杆菌的分离率变化显著,多重耐药鲍曼不动杆菌(MDRAB)占79.24%,泛耐药鲍曼不动杆菌(PDRAB)占17.20%。真菌共2 476株,占21.10%,白色假丝酵母菌仍占首位;光滑假丝酵母菌、克柔假丝酵母菌等非白色假丝酵母菌分离率逐年升高。结论:6年来临床常见细菌分离率及耐药菌株在各科室存在较大差异,可能与病种特点和各科室抗生素的使用强度(AUD)有关,同时与呼吸机的使用和各种介入性治疗等伴发院内感染密切相关。

Retrospective analysis of clinical common pathogenic bacteria during 2005 - 2010

Objective:To control clinical infection and provide reference for empirical administration,through retrospectively studying the varieties and variation trend of constituent ratio and the distribution characteristics of the ward of the separated clinical common pathogenic bacteria during 2005-2010.Methods: The records of clinical pathogenic bacteria,which were isolated from clinical specimens during 2005-2010,were dynamically compared and analyzed for the variation trend of constituent ratio and distribution characteristics of the ward.Results: A total of 11,733 strains of pathogens were separated during the six years,including 9 257 strains of bacteria(78.90%).The major pathogens by rank were Escherichia.coli,which accounted for 12.15%,followed by Staphylococcus.aureus(8.48%),Pseudomonas.aeruginosa,Acinetobacter.baumannii,Klebsiella pneumoniae,Enterobacter cloacae,Staphylococcus.haemolyticus,and Staphylococcus epidermidis.The Extended Spectrum Beta-Lactamases-producing(ESBLS) E.coli(37.10%),S.aureus of MRSA(81.81%),ESBLs-Producing K.pneumoniae(32.14%);Pan-drug resistant P.aeruginosa 19.55%),multidrug-resistant A.baumannii(79.24%) and the Pan-drug resistant A.baumannii(17.20%) were common drug resistant pathogens.Fungi were separated out of 2 476 plants(21.10%),and Candida albicans still ranked fungus infection first;In addition,Candida glabrata and Candida krusei non-albicans candida mycoderma's separation rate increased year by year.Conclusion: There were marked differences in the distribution of bacteria separation rate and the drug resistant pathogens among wards in the six years.The above phenomenon may be related to disease characteristics and antibiotic use density of each department,at the same time closely related to nosocomial infection which caused by the use of breathing machines and various kinds of interventional treatment.