伤口分泌物中1640株病原菌主要种类及药敏结果分析

的了解南方医院近3年患者伤口分泌物中病原菌主要种类及耐药谱，为合理使用抗生素提供依据。方法大多数细菌的鉴定和药敏试验利用BDPhoenix仪，少数利用手工鉴定和K—B法药敏试验。念珠菌利用显色平板分离和鉴定，K-B法药敏试验。数据分析用WHONET5．4软件。结果1640株细菌念珠菌主要种类为铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌、粪肠球菌、表皮葡萄球菌、鲍曼不动杆菌、溶血葡萄球菌和白色念珠菌。G^-杆菌中耐药率较低的为亚胺培南、头孢哌酮，舒巴坦、哌拉西林-他唑巴坦和阿米卡星。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶（ESBLs）的检出率为35．2％和32.3％。G^-球菌对万古霉素和替考拉宁的敏感率为100．0％，对其他抗生素的耐药率均较高。金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌和腐生葡萄球菌甲氧西林耐药率分别为33．8％、81．9％、80．9％和79．7％。念珠菌对两性霉素B和制菌霉素的耐药率均为0．0％。结论南方医院患者伤口分泌物中大肠埃希菌和肺炎克雷伯菌产ESBLs比例、非发酵G^-杆菌碳青霉烯类耐药率、葡萄球菌属甲氧西林耐药率均较高，应加强抗生素的合理使用。

Analysis of distribution and drug resistance spectrum of 1 640 clinical bacteria and candida isolates from wound secretion specimens

Objective To investigate distribution and drug resistance spectrum of bacteria and candida isolates from wound secretion specimens in local region for using antibiotic reasonably. Methods Most bacteria isolates were identified with BD Phoenix,a few were identified with handy work and K-B method. Candida isolates were identified with color display plates and K-B method. WHONET5.4 was applied for analysis. Results The common isolates in 1 640 strains were P. aeruginosa,S, aureu,E, coli,E, faecalis,S, epidermidis,A.baumannii,S.haemolyticus,and C. albicans. In gram negative bacillus,lower resistant rates of antibiotics were Imipenem, Cefoperazone/Sulbactam, Piperacillin/Tazobactam, and Amikacin. The incidences of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamase (ESBLs) were 35.2% and 32.3% respectively. In gram positive coccus,sensitive rates of Vancomyein and Teicoplanin were 100% ,resistant rates of others were higher. The methecillin resistant rates of S. aureu,S, epidermidis,S, haemolyticus and S. saprophyticus were 33.8%, 81.9%, 80.9%, and 79.7% respectively. In Candida isolates, resistant rates of Amphotericin B and Nystain were 0.0%. Conclusion The production ratios of ESBLs of E.coli and K. pneumoniae isolates,Carbopenem resistant rates of non-ferment gram negative bacillus,and Methicillin resistant rates of staphylococci were high. It is important to enforce the rational use of antibiotic.