近三年同期几种常见致病菌的耐药性变迁分析

目的分析佛山市第一人民医院2011-2013年第三季度临床分离的几种常见病原菌的耐药性变迁情况,为临床合理用药提供参考依据。方法采用法国梅里埃VITEK-Compact全自动微生物分析仪对分离菌进行鉴定及药敏试验,多耐药菌采用纸片扩散法,对所得数据采用WHONET 5.4软件进行统计分析。结果近三年同期分离的菌株以革兰阴性杆菌为主,肠杆菌分别是大肠埃希菌和肺炎克雷伯菌,非发酵菌分别是铜绿假单胞菌和鲍曼不动杆菌,革兰阳性球菌以葡萄球菌、肠球菌为主;肠杆菌科中,对碳青酶烯类抗生素几乎没有耐药情况,铜绿假单胞菌对喹诺酮类及氨基糖苷类抗生素耐药率最低,鲍曼不动杆菌除对喹诺酮类耐药率稍低外,对其他所有抗菌药物均明显耐药,除万古霉素、利奈唑胺、呋喃妥因和替加环素外,葡萄球菌及肠球菌对其余抗菌药物均高度耐药。结论常见致病菌均存在耐药情况,细菌耐药加大了临床治疗难度。应定期进行耐药性监测,了解细菌耐药性的动态变化,为临床用药提供指导。

Analysis of drug resistance changes of several common pathogensin recent three years

Objective To analyze the drug resistance changes of several common pathogens isolated from the clinic and our hospital in the third quarter in 2011-2013, and provide the reference for the clinical rational drug use. Methods The bioMerieux VITEK-Compact automatic microorganism analyzer made in Frenchwas used for identification and drug sensitivity test of isolated bacteria.Disk diffusion method was used for testing multi drug resistant bacteria. 5.4 software was used for statistical analysis of data obtained from WHONET. Results The main bacterial strains isolated were the gram negative bacilli in recent three years. Intestinal bacteria were Escherichia coli and Klebsiella pneumoniae, non fermentation bacteria were Pseudomonas aeruginosa and Bauman acinetobacter,Gram positive cocci were mainly Staphylococcus aureus and Enterococcus.Enterobacteriaceae almost had no resistance to carbapenem antibiotics. Pseudomonas aeruginosa had the lowest resistance rate toquinolone and aminoglycoside antibiotics. Bauman acinetobacter had obvious resistance to all antibiotics except a lower resistance to quinolone.Except to vancomycin, linezolid, nitrofurantoin and tigecycline, Staphylococcus and Interococcus were significantly resistantto otherantimicrobials. Conclusion Common pathogenic bacteriaaredrug resistant. Multi-drug resistance of the common pathogen increases the difficulty of clinical treatment. Therefore we should regularly monitor and understand the dynamic changes of drugresistance of the pathogenic bacteria, and provide guidance for clinical practice.