2013-2015年郑州市中医院临床常见病原菌分布及耐药性分析

发布时间：2018-03-11 06:54

本文选题：病原菌　切入点：耐药监测　出处：《现代预防医学》2016年18期 　论文类型：期刊论文

【摘要】：目的了解2013-2015年临床细菌分布和耐药性,为临床合理使用抗菌药物提供依据。方法对2013-2015年临床病原菌分布及耐药性进行回顾性研究。采用珠海迪尔医学细菌测定系统对4 439株病原菌进行细菌鉴定和药敏试验。结果 2013-2015年临床共分离4 439株病原菌,革兰阴性菌占78.3%,革兰阳性菌占17.6%,真菌占4.1%,其中革兰阴性菌前4位依次为铜绿假单胞菌(22.2%)、肺炎克雷伯菌(16.5%)、大肠埃希菌(15.3%)和鲍曼不动杆菌(9.5%)。药敏结果显示,临床常见病原菌对大部分抗菌药物有不同程度耐药且特点各不相同。3年中铜绿假单胞菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢吡肟、阿米卡星、多黏菌素B和氨曲南的耐药率始终低于30%,平均耐药率分别为13.2%、17.5%、18.4%、9.5%、4.8%和8.1%。鲍曼不动杆菌对多黏菌素B耐药率最低,为4.7%;耐药率增幅最大的为阿米卡星,耐药率由2013年的27.8%上升至2015年的75.0%。未发现对亚胺培南耐药大肠埃希菌。肺炎克雷伯菌对美罗培南和亚胺培南的耐药率分别为17.4%和16.6%。57.4%大肠埃希菌和18.8%肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs),泛耐药鲍曼不动杆菌(PDR)检出率为1.3%。未检出对万古霉素耐药革兰阳性球菌。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为40.9%。结论医院感染病原菌以革兰阴性菌为主且耐药率较高,需加强细菌耐药性监测,为合理用药提供依据。
[Abstract]:Objective to investigate the distribution and drug resistance of clinical bacteria from 2013 to 2015, Methods the distribution and drug resistance of clinical pathogens from 2013 to 2015 were studied retrospectively. 4 439 strains of pathogenic bacteria were identified and drug sensitive by Zhuhai Deer Medical bacteria Test system. Results A total of 4,439 strains of pathogenic bacteria were isolated from the clinic between 2013 and 2015. Gram-negative bacteria accounted for 78.3%, Gram-positive bacteria 17.6% and fungi for 4.1%. Among them, the first four gram-negative bacteria were Pseudomonas aeruginosa 22.2um, Klebsiella pneumoniae 16.551.) and Acinetobacter baumannii 9.5. In 3 years, Pseudomonas aeruginosa had different resistance to cefoperazone / sulbactam, piperacillin / tazobactam, cefepime, amikacin, and so on. The drug resistance rates of polymyxin B and aztreonam were always lower than 30%, and the average drug resistance rates were 13. 2% and 17. 5% and 18. 4% and 8. 1%, respectively. Acinetobacter baumannii had the lowest resistance rate to polymyxin B, which was 4. 7%, and the highest rate of drug resistance was amikacin. The resistance rate of Klebsiella pneumoniae to meropenem and imipenem was 17.4% and 16.67.4% respectively. The detection rate of extended-spectrum 尾 -lactamase producing ESBLsN and pan-drug-resistant Acinetobacter baumannii was 1.3. The detection rate of vancomycin resistant Gram-positive cocci and methicillin-resistant Staphylococcus aureus MRSAs was 40.90.Conclusion Nosocomial infection is a pathogen of nosocomial infection. Gram-negative bacteria were the main bacteria and the drug resistance rate was higher. It is necessary to strengthen the monitoring of bacterial resistance and provide the basis for rational use of drugs.
【作者单位】：郑州铁路职业技术学院医学技术系;
【分类号】：R446.5

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