中医院临床分离菌株耐药性观察

目的调查中医院临床分离菌株分布及其耐药性,为合理使用抗菌药物提供参考。方法以临床标本分离菌株为对象,采用纸片扩散法测定其对常用抗菌药物耐药感性。结果该医院在2007-2010年间从病人标本中共分离出细菌20 725株,其中革兰阴性菌占84.3%,革兰阳性菌占15.7%。革兰阴性菌以大肠埃希菌和肺炎克雷伯菌居多,其中产超广谱β内酰胺酶的大肠埃希菌和肺炎克雷伯菌检出率分别为58.5%和29.1%。革兰阳性菌以金黄色葡萄球菌为主,其中MRSA分离率由2007年的44.6%增加到2010年的72.7%。临床分离菌株多数具有耐药,屎肠球菌对多数抗菌药物的耐药率超过80%,铜绿假单胞菌和鲍曼不动杆菌对多数抗菌药物的耐药率超过90%,4年共检出耐万古霉素的肠球菌15株。结论临床分离细菌以革兰阴性菌为主,耐药率呈逐年升高趋势,MRSA菌株检出率呈现增加趋势。

OBSERVATION ON ANTIBIOTIC - RESISTANCE TO CLINICAL ISOLATED STRAINS IN TRADITIONAL CHINESE MEDICAL HOSPITAL

Objective To investigate the distribution and antibiotic-resistance of clinical isolated strains in a traditional chinese medical hospital for giving information to rational use of antibiotics.Methods All the clinical isolates strains were collected from the hospital in 2007 to 2010 and disc diffusion tests were used to observe the drug susceptibility of this strains.Results A total of 20 725 bacteria isolates and their antibacterial susceptibility data were collected,which included gram-negative bacterial strains(84.3%) and gram-positive bacterial strains(15.7%).Escherichia coli and Klebsiella pneumoniae were the top two isolates in gram-negative bacterial strains.The positive rates of E.coli and K.pneumoniae isolates that producing extended spectrum-β-lactamases(ESBLs) were 58.5% and 29.1% respectively.Staphylococcus aureus was the most common isolates in gram-positive bacterial strains.The detection rates of methicillin resistant S.aureus(MRSA)increased from 44.6% in 2007 to 72.7% in 2010.Most of isolates were antibiotic-resistance strains.The resistance rate of Enterococcus faecalis to most of common antibiotics were over 80% and those of Pseudomonas aeruginosa and A.baumannii were over 90%.Totally 15 strains Vancomycin-resistant Enterococcus were detected during these 4 years.Conclusion Gram-negative bacterial strains are most common clinical isolates and the antibiotic-resistance rate of strains increases year by year.The detection rate of MRSA keeps increasing trend.