2013年临床常见病原菌分布及耐药性分析

摘要

目的：了解医院2013年病原菌分布及其耐药性，为临床合理选择抗菌药物提供依据。方法：对2013年医院临床标本细菌鉴定结果及药敏结果进行统计分析。结果：共分离出病原菌1374株，其中革兰阳性菌401株，占29.2%，革兰阴性菌819株，占59.6%，真菌154株，占11.2%。前5位的细菌依次为大肠埃希菌345株，占25.1%，凝固酶阴性葡萄球菌183株，占13.3%，金黄色葡萄球菌156株，占11.4%，克雷伯杆菌138株，占10.0%，鲍曼不动杆菌81例，占5.9%。肠杆菌科细菌对碳青霉烯类抗菌药物高度敏感，耐药率<0.9%，对氨苄西林耐药率较高>78.6%。耐甲氧西林的凝固酶阴性葡萄球菌(MRCNS)和耐甲氧西林的金黄色葡萄球菌(MRSA)分别占75.4%和16.0%。结论：临床分离的病原菌以革兰阴性菌为主，其中大肠埃希菌比例高。革兰阳性菌中耐甲氧西林的凝固酶阴性葡萄球菌所占比例高。分离菌株的耐药现象普遍存在，临床应根据药敏结果合理选用抗菌药物，减少病原菌耐药的产生。%Objective:To investigate the distribution and drug resistance of clinical pathogenic bacteria in 2013 and provide bases for rational of antibiotics.Method:The bacterial indentification results of clinical specimens and the results of drug susceptibility testing performed in 2013 were statistically analyzed.Result:A total of 1374 strains of pathogens were isolated,including 401(29.2%) strains of gram-positive cocci,819(59.6%) strains of gram-negative bacilli,and 154(11.2%) strains of fungi. The Escherichia coli(345 strains),coagulase-negative Staphylococcus(183 strains),Staphylococcus aureus(156 strains), Klebsiella pneumoniae(138 strains),and Acinetobacter baumannii(81 strains) were the top 5 species of the isolated pathogens,accounting for 25.1%,13.3%, 11.4%,10.0%,5.9%.The resistance rates of Enterobacteriaceae against Carbapenem antibiotics,monobactams were less than 0.9%,but more than 78.6%about ampicillin.MRCNS accounted for 75.4%,MRSA accounted for 16.0%.Conclusion:The isolated pathogenic bacteria dominant in the Escherichia coli,which are mainly caused by the gram-negative bacilli.The MRCNS have a big portion in gram-positive cocci.The drug resistance of the isolated pathogenic bacteria is serious, the Susceptibility results should be performed in clinical practice so as to reasonably use antibiotics.