2012-2013年病原菌分布与对抗菌药物的药敏分析

发布时间：2018-06-19 00:03

本文选题：病原菌 + 耐药趋势　；参考：《中华医院感染学杂志》2016年01期

【摘要】：目的分析住院患者常见病原菌的药敏性及抗菌药物的用药频度(DDDs),为临床合理应用抗菌药物提供参考。方法对医院2012年1月1日-2013年12月31日住院患者病原菌分离株及其对抗菌药物的药敏性进行回顾性分析,用纸片扩散法(K-B法),部分细菌使用VITEK系统配套的药敏卡进行药敏试验;同时计算抗菌药物的DDDs。结果共分离病原菌9 189株,其中革兰阴性菌6 784株、革兰阳性菌2 405株;分离的前5位病原菌分别为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌和凝固酶阴性葡萄球菌;革兰阳性球菌对万古霉素、替考拉宁、利奈唑胺的敏感率较高,约100.0%;甲氧西林敏感金黄色葡萄球菌(MSSA)对克林霉素的敏感率最低,且呈明显下降趋势;鲍氏不动杆菌对所有抗菌药物的敏感性均呈明显下降趋势;大肠埃希菌对氟喹诺酮类的敏感率仅为24.8%~40.9%。结论鲍氏不动杆菌耐药日趋严重,其他革兰阴性菌和革兰阳性菌的耐药趋势较稳定;抗菌药物的DDDs与细菌耐药性无确定关系;加强对鲍氏不动杆菌的耐药性监测,结合药敏试验调整用药,对控制细菌耐药性及促进临床合理用药具有重要意义。
[Abstract]:Objective to analyze the antimicrobial susceptibility of common pathogens and the frequency of antimicrobial use in inpatients and to provide reference for the rational application of antimicrobial agents in clinic. Methods A retrospective analysis was made on the isolates of pathogenic bacteria from January 1, 2012 to December 31, 2013, and their susceptibility to antimicrobial agents. The drug sensitivity tests were carried out by disk diffusion method with K-B method, and some bacteria with VITEK drug sensitive cards. At the same time, the DDDs of antimicrobial agents were calculated. Results A total of 9 189 strains of pathogenic bacteria were isolated, of which 6 784 were gram-negative bacteria and 2 405 were gram-positive bacteria, the top 5 pathogens were Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae, respectively. Acinetobacter baumannii and coagulase-negative staphylococcus; Gram-positive cocci have the highest sensitivity to vancomycin, teicoplanin and linazolamine, about 100.0.The methicillin-sensitive Staphylococcus aureus (MSSAs) has the lowest sensitivity to clindamycin. The sensitivity of Acinetobacter baumannii to all antimicrobial agents decreased obviously, and the sensitivity rate of Escherichia coli to fluoroquinolones was only 24.80.90%. Conclusion the drug resistance of Acinetobacter baumannii is becoming more serious, the resistance trend of other Gram-negative bacteria and Gram-positive bacteria is stable, there is no definite relationship between the DDDs of antimicrobial agents and bacterial resistance, and the surveillance of drug resistance of Acinetobacter baumannii is strengthened. It is of great significance to control bacterial drug resistance and promote rational drug use in clinic by adjusting drug use in combination with drug sensitivity test.
【作者单位】：首都医科大学附属北京朝阳医院药事部;
【基金】：国家自然科学基金资助项目(81302822)
【分类号】：R446.5

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