摘要
目的:探讨2007～2009年重庆市巴南区人民医院感染病原菌的构成、临床分布特点及耐药谱的动态变化,以指导临床合理应用抗生素。方法:收集临床标本,包括血液、腹水、痰液、伤口分泌物等标本,采用VITEK微生物自动分析仪进行培养、细菌鉴定并测定药敏,结果依据1999年NCCLS判断标准,对2007～2009年送检的各类标本所分离的菌株进行鉴定及药敏测定。结果:各类标本共2 980份,分离500株,阳性率为16.8%。其中革兰阳性球菌150株,占30%,革兰阴性杆菌350株,占70%。分离菌株中以铜绿假胞菌、大肠杆菌、金黄色葡萄球菌、肺炎克雷佰杆菌最多。铜绿假胞菌、大肠杆菌、肺炎克雷佰杆菌对医院常用的氨苄西林、哌拉西林、替卡西林等耐药率均在5%以上,仅对亚胺培南的耐药率在20%以下。金葡菌、表葡菌、粪肠球菌对青霉素、苯唑西林、头孢唑啉、红霉素、环丙沙星的耐药率均在50%以上,对万古霉素的耐药率在10%以下。结论:笔者所在医院患者中分离的细菌以革兰阴性杆菌为主,约为革兰阳性球菌的2倍。两类细菌对临床常用的抗菌素都有很高的耐药率。因此,应该了解各菌种的分布,和耐药特点,合理使用抗菌药物,并严密监控新的耐药菌的产生,才能提高临床治愈率。
Objective：To explore the compositions of nosocomial infection bacteria,clinical distribution and drug resistant spectrum in People＇ s Hospital ofBanan district,Chongqing during 2007-2009,which may provide clinical practice with evidence on how to use anitbiotics,Methods：Clinical samples including blood,ascites,sputums,various secretions,etc were collected to culture bacteria during 2007-2009.Isolation and drug sensitivity test of the bacteria were done by means of VITEK microorganism autoananlyser, and the results were assessed according to criteria of NCCLS in 1999.Results：500 strains of bacteria were isolated from 2 980 clinical samples with positive cultural rate of 16.8%.Among 500 strains,Gram stain positive bacteria consisted of 150 strains,the ratio was 30%.Gram stain negative bacteria 350 strains accounting for 70%,Pseudmonas aerugionosa, Bacillus coli, Staphylococcus anreus. Klebesiella pneumoniae were the major pathogens among the isolation strains.The drug resistant rate of Pseudmonas aerugionosa. Bacillus coll. Klebesiella pneumoniae to ampicin,piperaeillin,TieavCBlin were above 50%.But imipenem still kept good sensitiviy with drug resistant rate less than 20%.The drug resistant rate of Staphylococcus autens.Staphylococcus epidcrmidis,Enterococcus faecalis to penicillin,oxacillin, ~Cephazolin,erythromycin,Ciprofloxacm were also more than 50%,only vancomycin kept lower drug resistant rate less than 10%. Conclusion：The pathogens isolated from clinical samples in my hospital were mainly gram negative bacteria, which more than two times that of gram positive germs Both of gram positive and gram negative bacteria showed high drug resistant rate.So it was very important that knew the information about bacteria distribution and drug resistant spectrum in clinical practice.We also should pay more attention to newly appeared resistant and use antibiotics guided by culture and drug sensitivity results.
出处
《中国医药导刊》
2011年第7期1249-1250,共2页
Chinese Journal of Medicinal Guide
关键词
医院感染
耐药性
感染
抗菌素应用
Nosocomial infection：Drug resistance
lnfection
Antiboioties application
