摘要
目的:分析2011年老年科住院患者感染病原菌的分布规律及耐药性,以指导临床合理用药。方法:采用API或Vitek2compact鉴定系统鉴定细菌及真菌;纸片扩散法测定细菌药物敏感性;WHONET5.6软件进行统计分析。结果:老年科住院患者感染病原菌临床分离共993株,其中革兰阴性菌657株(66.2%),革兰阳性菌124株(12.5%),真菌119株(12.0%),其中检出率最高的病原菌是铜绿假单胞菌,共254株,占25.6%,其次是不动杆菌属(19.0%)和克雷伯菌属(12.7%)。耐药性分析结果显示:非发酵菌中,铜绿假单胞菌对大部分抗菌药的耐药率>60.0%;不动杆菌属对大部分抗菌药的耐药率>70.0%,其中对亚胺培南和美罗培南的耐药率分别为88.7%和91.1%;大肠埃希菌对头孢菌素类抗菌药的耐药率>75.0%,对亚胺培南和美罗培南耐药率分别为0.0%和1.5%;克雷伯菌属对头孢菌素类抗菌药的耐药率在80.0%左右,对亚胺培南和美罗培南耐药率高达35.2%和42.3%;葡萄球菌属尚未发现对万古霉素耐药的菌株,但对其他多种抗菌药的耐药率较高,如对青霉素G、哌拉西林/他唑巴坦和头孢西丁的耐药率均>65.0%。结论:2011年老年科感染病原菌分布已发生变迁,各种细菌对多种抗菌药的耐药率不断上升,尤其不动杆菌和肠杆菌科细菌对碳青酶烯类药物耐药严重,应引起高度重视。
Objective：In order to guide clinical doctor to select antimicrobial agents rationally,we sought to analyze the pathogen distribution and resistance pattern of positive clinical specimens from the department of gerontology of our hospital in 2011. Methods： The bacteria and fungi were identified by API or Vitek 2 compact system.The susceptibility of antimicrobial and antifungal agents was tested by K-B and the data were analyzed by WHONET5.6 software.Results：A total of 993 strains were isolated and collected in the department of gerontology,including 657 strains（66.2%） of Gram-negative bacilli,124 strains（12.5%） of Grampositive cocci and 119 fungi（12.0%）.The pathogen of the highest isolating rate was Pseudomonas aeruginosa,which accounted for 25.6%,the next was Acinetobacter species（19.0%） as well as Klebsiella（12.7%）.Resistance analysis showed that among nonfermenters,Pseudomonas aeruginosa was resistant to the most of the antimicrobial agents,and Acinetobacter for most antimicrobial resistant was more than 70.0%,however for the resistance pattern of imipenem and meropenem were 88.7% and 91.1% respectively. Meanwhile,Escherichia coli were resistant to the most of cephalosporins,but for the resistance pattern of imipenem and meropenem were 0.0% and 1.5%,respectively.The resistance pattern of Klebsiella was higher than Escherichia coli,and for the resistance pattern of imipenem and meropenem were 35.2% and 42.3%,respectively.As for Staphylococcus species,none was found to resistant to vancomycin.However,they were resistant to many other antimicrobial agents.Conclusion：The pathogens in our department of gerontology have generated diversity,and the resistance pattern of the pathogens is rising.Especially,the resistance to carbapenems among Acinetobacter species and Enterobacteriaceae were serious,and we need to pay more attention on this issue.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2013年第7期975-979,共5页
Journal of Nanjing Medical University(Natural Sciences)
基金
国家自然科学基金项目(81000754)
江苏省实验诊断学重点实验室重大课题(XK201114)
