北京市某三甲医院病原菌结构及耐药性变迁

摘要

Objective To investigate the profile of the distribution and antibiotic resistances of clinic pathogenic microorganism isolated from 2005 to 2009 ,and to offer scientific information for clinical anti-infection treatment. Methods To analyze the data of pathogen identification and susceptive test from 2005 to2009. Results A total number of micoorganism isolated was increase year by year. Most of the isolated microorganism are gram negative bacilli. The dynamic analysis of the bacteria distribution showed that infections caused by Staphylococcus aureu, Escherichia coli and Pseud omonas aeruginosa exhibited a decreasing tendency, while the infections caused by the Fungi,Klebsiella pneumoniae,Acinetobacter baumannii were increasing significantly. The dynamic analysis of antibiotic resistance showed that MRSA highly resist to most of the antibiotics, except Vancomycin, Nitrofurantoin and Cotrimoxazole. The resistance rate of Klebsiella pneumoniae to the third generation cephalosporin increased during this five years. Conclusion The significant changes in infectious pathogens in our hospital were an decrease in Gram-positive cocci and increase in Fun gi,Klebsiella pneumoniae and Acinetobacter baumannii.%目的 了解近5年北京地区某三甲医院临床分离的病原菌结构和耐药性变迁,为临床抗感染治疗提供依据.方法 统计分析2005～2009年患者各类标本分离细菌的鉴定及药敏试验结果.结果 5年间该院分离出的病原菌数目逐年增加,病原菌构成以革兰阴性杆菌为主(47.6%～50.0%),革兰阳性球菌(19.7%～20.9%)和真菌(18.1%～19.7%)次之.金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌构成比均有下降趋势,真菌、肺炎克雷伯菌、鲍曼不动杆菌构成比有上升趋势.药敏结果显示MRSA对常用抗生素高度耐药,仅对万古霉素、呋喃妥因、复方新诺明的耐药率较低;革兰阴性杆菌中,肺炎克雷伯菌对第3代头孢耐药率上升,2009年的耐药率达到最高.结论 该院临床感染的病原微生物种类中革兰阳性球菌比例5年间明显下降,院内感染控制较好,但应注意真菌及产ESBLs的肺炎克雷伯菌及鲍曼不动杆菌感染呈上升趋势.