3144株临床分离细菌和念珠菌的分布及耐药性分析

目的了解本院临床分离细菌和念珠菌的分布特征和耐药性,为合理使用抗生素提供依据。方法大多数分离细菌的鉴定和药敏试验利用BD Phoenix仪,少数利用手工鉴定和K-B法。念珠菌利用显色平板进行分离和鉴定,K-B法测药敏。结果3144株细菌和念珠菌中前6位的种类及百分比为白色念珠菌12.02%、铜绿假单胞菌11.10%、大肠埃希菌9.64%、金黄色葡萄球菌7.09%、表皮葡萄球菌6.36%和肺炎型肺炎克雷伯菌6.14%。G-杆菌中耐药率较低的为亚安培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦和阿米卡星。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44.2%和43.5%。G＋球菌耐药率较低的为万古霉素、替考拉宁、呋喃妥因、阿米卡星、氯霉素、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦。金黄色葡萄球菌和凝固酶阴性葡萄球菌对甲氧西林耐药率分别为52.1%和65.1%。念珠菌对两性霉素B和制菌霉素的耐药率均为0。结论本院临床分离肠杆菌科各种细菌产ESBLs水平、非发酵菌耐药率和葡萄球菌对甲氧西林耐药率均较高,应加强抗生素的合理使用。

Distribution and Drug Resistance Spectrum of 3144 Bacteria and Candida Clinical Isolates

Objective To investigate distribution and drug resistance spectrum of clinical isolates of bacteria and Candida in local region. Method Most bacteria isolates were identified by BD Phoenix, and a few were identified by K-B method. Candida isolates were identified by color display plate and by K-B method. WHONET5.4 software was used for data analysis. Result The common isolates in 3144 samples were C.albicans （12.02%）, P. aeruginosa （11.10%）, E.coli （9.64%）, S.aureu （7.09%）, S.epidermidis （6.36%）, and K.pneumoniae （6.14%）. Gram negative isolates showed lower resistant rate to Imipenem, Piperacillin/Tazobactam, Cefoperazone/Sulbactam, and Amikacin. The incidences of E.coli and K.pneumoniae isolates producing extended spectrum beta-lactamase （ESBLs） were 44.2% and 43.5%, respectively. Gram positive isolates showed a lower resistant rate to Vancomycin, Teicoplanin, Nitrofurantoin, Amikacin, Chloramphenicol, Cefoperazone/Sulbactam, and Piperacillin/Tazobactam. The methecillin resistant rates of S.aureu and coagulase negative staphylococcus were 52.1% and 65.1%, respectively. In Cand/da isolates, resistant rates of Amphotericin B and Nystain were both 0. Conclusion The production ratio of ESBLs, multi-drug resistance of non-fermenters and methecillin resistance of staphylococcus in local region were high. It is important to promote the rational use of antimicrobial agents.