2011-2015年心血管病医院临床分离菌分布及耐药性分析

摘要

Objective To analyze the composition of the major clinical isolated bacterials for last 5 years and their drug resistance is beneficial to the use of antimicrobial agents in clinic.Methods The constituent ratio and drug resistance rates of the main clinical pathogens,isolated from the clinically submitted specimens during 2011 to 2015,were analyed by WHONET 5.6 statistical software,and were also statically analyzed by VITEK MS and VITEK 2 compact.Results The top five Gram-negative pathogenic bacteria isolated from our hospital from 2011 to 2015 were Klebsiella pneumoniae,Pseudomonas aeruginosa,Enterobacter cloacae,Acinetobacter and Escherichia coli.The major Gram-positive pathogenic bacteria on the top five positions were coagulase negative Staphylococci,Staphylococcus aureus,Enterococcus faecalis,Enterococcus faecium and Streptococcus pneumonia.Conclusion The constituent ratios of the major pathogens were generally stable for the past five years.The majority of the Gramnegative bacteria were senscitive for the forth generation of cephalosporins and penicillium carbon alkene.Penicillium carbon alkene was still effective for Gram-negative bacteria.There was no vancomycin resistant Staphylococcus aureus.Surveillance of the antimicrobial drug resistance of clinical isolates is very important to guide the application of antibiotics and to reduce the generation of resistance.%目的 了解2011-2015年我院临床主要分离菌的分布及细菌耐药状况,为合理使用抗生素提供依据,以减少不合理用药导致的细菌耐药.方法 采用法国梅里埃VITEK MS质谱仪及VITEK2 Compact进行鉴定和药敏试验,用WHONET 5.6软件进行统计分析.结果 2011-2015年前5位革兰阴性菌为肺炎克雷伯菌、铜绿假单胞菌、阴沟肠杆菌、鲍曼不动杆菌、大肠埃希菌.革兰阳性菌前5位为凝固酶阴性葡萄球菌、金黄色葡萄球菌、粪肠球菌、屎肠球菌和肺炎链球菌.结论 5年来主要分离菌构成比虽有波动,但总体较稳定;主要革兰阴性菌对第四代头孢及碳青霉烯类敏感性较高,碳青霉烯类仍然是治疗革兰阴性菌的有效药物;未发现耐万古霉素的金黄色葡萄球菌.对临床分离菌进行耐药性监测,有利于指导临床合理用药.