2014年某院临床常见病原菌的分布及耐药性分析

发布时间：2018-03-06 08:14

本文选题：细菌耐药性　切入点：抗菌药物　出处：《临床输血与检验》2017年01期 　论文类型：期刊论文

【摘要】：目的了解本院2014年临床分离菌对常见抗生素的耐药状况,为临床医生合理选择抗菌药物提供参考依据,减少和延缓耐药菌的产生。方法采用珠海迪尔公司DL-96全自动细菌鉴定/药敏分析仪,对2014年各科室送检标本中培养分离出的1 221株条件致病菌进行回顾性分析。结果1 221株临床分离菌中革兰阳性球菌440株(占36.04%),革兰阴性杆菌781株(占63.96%);革兰阳性球菌中排列前3位的分别是金黄色葡萄球菌149株(1 2.20%)、凝固酶阴性葡萄球菌1 23株(10.07%)、肠球菌124株(1 0.1 6%);革兰阴性杆菌中肠杆菌科细菌排列前2位的分别是大肠埃希菌245株(20.06%)、肺炎克雷伯菌162株(1 3.27%);非发酵菌中以铜绿假单胞菌和鲍曼不动杆菌最常见,分别为143株(11.71%)和122株(9.99%)。葡萄球菌属中耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的76.71%和81.4%,未发现耐万古霉素和替考拉宁的葡萄球菌。在革兰阴性杆菌中产超广谱内酰胺酶(ESBLs)检出率占大肠埃希菌和肺炎克雷伯菌的77.2%和26.0%,均对碳青霉烯类具有很好的敏感性。结论 2014年度院内病原菌以革兰阴性杆菌居多,且细菌多重耐药日趋严重,因此开展细菌耐药监测和掌握细菌耐药变迁动态,对指导临床合理应用抗菌药物和有效控制院内感染具有重要意义。
[Abstract]:Objective to investigate the drug resistance of clinical isolates to common antibiotics in our hospital in 2014, and to provide reference for clinicians to select antibiotics reasonably. Methods DL-96 automatic bacterial identification / drug sensitivity analyzer was used to reduce and delay the production of drug-resistant bacteria. A retrospective analysis of 1 221 strains of opportunistic pathogens isolated from specimens from various departments in 2014 was carried out. Results 440 strains of gram-positive cocci (36.04%), 781 strains of gram-negative bacilli (63.96%) and 1,221 strains of Gram-positive bacteria (63.96%) were isolated from 1 221 strains of clinical isolates. Among them, 149 strains of Staphylococcus aureus, 123 strains of coagulase negative Staphylococcus, 124 strains of Enterococcus and 124 strains of Enterococcus were ranked among the top 3 strains of Staphylococcus aureus, respectively, and those of Enterobacteriaceae were Escherichia coli. 245 strains of M. pneumoniae and 162 strains of Klebsiella pneumoniae were found to be the most common in non-fermentative bacteria, Pseudomonas aeruginosa and Acinetobacter baumannii were the most common. The positive rates of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococcus were 76.71% of Staphylococcus aureus and coagulase-negative staphylococcus, respectively. No vancomycin and teicoplanin resistant staphylococci were found. The detection rate of extended-spectrum lactamases in gram-negative bacilli accounted for 77.2% and 26.0% of Escherichia coli and Klebsiella pneumoniae, which were good for carbapenem. Conclusion Gram-negative bacilli are the most pathogenic bacteria in hospital in 2014. The multidrug resistance of bacteria is becoming more and more serious, so it is of great significance to monitor bacterial drug resistance and grasp the dynamics of bacterial resistance change in order to guide the rational use of antimicrobial agents in clinic and to effectively control nosocomial infection.
【作者单位】：湖北省武汉市第十一医院检验科;
【分类号】：R446.5

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