摘要
目的了解医院感染病原菌分布及耐药,以指导医院合理使用抗菌药物。方法选择医院2011年1-12月临床分离的病原菌107株,对病原菌进行涂片革兰染色,依据染色结果,采用VITEK-32全自动微生物分析/药敏系统及配套细菌鉴定卡片进行分析,根据2007年美国临床实验室标准化研究所(CLSI)制定的标准进行试验及结果判定。结果 107株病原菌以革兰阴性菌为主,占55.1%;其次为革兰阳性球菌,占40.9%;主要革兰阳性菌对苯唑西林、红霉素、青霉素等抗菌药物耐药率较高,此外,还发现凝固酶阴性葡萄球菌、金黄色葡萄球菌和肠球菌属对万古霉素均敏感,耐药率分别为5.9%、9.1%和11.1%;大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌对医院常用抗菌药物耐药率均较高,多数>50.0%,且表现为多药耐药现象,大肠埃希菌对氨苄西林、环丙沙星和左氧氟沙星的耐药率均>80.0%。此外,研究还发现大肠埃希菌和肺炎克雷伯菌对氨苄西林的耐药率分别高达95.0%和91.7%。结论医院感染病原菌分布较为集中,以革兰阴性菌为主,且均存在多药耐药问题,这可能与医院的抗菌药物不合理使用和滥用有关。
OBJECTIVE To explore the distribution of the pathogens causing nosocomial infections and current status of drug resistance so as to guide the reasonable use of antibiotics.METHODS From Jan 2011 to Dec 2011,a total of 107 strains of pathogens were isolated from the hospital,the gram-staining smear was made for the pathogens,according the dyeing results,and the VITEK-32 automatic microorganism identification card system and the supporting bacterial identification card were adopted.The testing results were determined according to the standards developed by the United States standardization of Clinical and Laboratory Research Institute（CLSI） 2007.RESULTS Of 107 strains of pathogens isolated,the gram-negative bacteria accounted for 55.1%,and the gram-positive cocci accounted for 40.9%.The main species of the gram-positive bacteria were highly resistant to oxacillin,erythromycin,and penicillin.In addition,the coagulase-negative Staphylococcus epidermidis,Staphylococcus aureus and Enterococcus were all sensitive to vancomycin,the drug resistance rates were 5.9%,9.1%,and 11.1%,respectively.Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa were highly resistant to most of the commonly used antibiotics with the drug resistance rate higher than 50.0% and showed multidrug-resistant.The drug resistance rates of the E.coli strains to ampicillin,ciprofloxacin and levofloxacin were higher than 80.0%.In addition,the study also indicated that the drug resistance rates of the E.coli and K.pneumoniae to ampicillin were 95.0% and 91.7%,respectively.CONCLUSION The gram-negative bacteria are the predominant pathogens causing nosocomial infections and show multidrug-resistant,which may be related to the unreasonable use of antibiotics in the hospital.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第5期1169-1171,共3页
Chinese Journal of Nosocomiology
关键词
医院感染
病原菌
耐药率
Nosocomial infection
Pathogen
Drug resistance
