摘要
目的探讨2003-2007年间枣庄市主要病原菌流行及耐药趋势。方法采用回顾性调查分析法,对收集的5年间枣庄市3家主要医院临床分离病原菌的数据进行统计分析。结果从3家医院得到的5年间共4520株分离菌的鉴定和药物敏感数据分析表明,分离菌株以革兰阴性菌为主(60.10%)。肠杆菌科细菌在2004年明显下降后基本稳定,占前3位的是大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌。非发酵菌总体呈上升趋势,铜绿假单胞菌和鲍曼不动杆菌始终居前2位。革兰阳性菌在2003至2006年间呈上升趋势,至2007年出现下降,各菌所占比例5年来变化不大,前3位依次是金葡菌、表皮葡萄球菌和溶血葡萄球菌。科室分布方面,内科、外科均以非发酵菌、肠杆菌科细菌所占比例较大,重症监护病房(ICU)以非发酵菌所占比例较大。感染患者的年龄分布方面,革兰阳性菌感染以31～40岁人群为主;老年患者在肠杆菌科细菌感染中所占比例明显上升;历年非发酵菌感染均以老年患者为主,且高龄组有进一步加剧趋势。药敏试验显示主要病原菌对常用抗菌药物耐药严重,对常见耐药类型的检测普遍存在缺失,影响临床判读。结论本地区主要病原菌流行病学调查和耐药检测尚待加强,为加强临床合理用药,有必要建立本地区的检测网络。
Objective To investigate the main pathogen prevalence and resistance trends from 2003 to 2007 in Zaozhuang. Methods The main pathogen prevalence and resistance trends were analyzed on the data of clinical separated pathogenic bacteria in three hospitals of Zaozhuang during the five years. Results The majority were gram-negative strains （60.10%） in totally 4 520 isolates. Among them Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae were the top three. The occupation of non-zymocytes showed an upward trend in general, among them Pseudomonas aeruginosa and Acinetobacter baumannii were the top two. The occupation of gram-positive bacteria showed an upward trend during the year of 2003 to 2006 and decreased in 2007. The proportion of each strain in gram-positive bacteria changed little and Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus haemolyticus were the top three, The major pathogenic bacteria in internal medicine and surgery were non-zymocytes and enterobacteriaceae, and the major pathogenic bacteria in intensive care unit （ICU） were non-zymocytes. Gram-positive bacteria were the major pathogenic bacteria in patients of 31-40 years old. The proportion of elderly patients in enterobacteriaceae infection was noticeable increasing. Elderly patients were also the main group in patients with non-zymocytes infection. Commonly used antibacterials showed serious resistance to major pathogens. The test of common resistant type was insufficient. Conclusion For the purpose of rational drug use, regional survey of main pathogen prevalence and drug resistance test should be strengthened and the establishment of regional monitoring network would be necessary.
出处
《世界临床药物》
CAS
2010年第3期168-173,共6页
World Clinical Drug
关键词
主要病原菌
流行病学
耐药率
山东
枣庄
major pathogen
epidemiology
resistance rate
Shandong
Zaozhuang
