摘要
目的 了解精神专科医院2010年～2012年度临床分离病原菌的分布和耐药性,促进抗菌药物的合理使用.方法 对2010年～2012年临床送检标本按常规进行病原菌分离,采用Vitek-Two系统对病原菌进行鉴定并测定其对相应抗生素的耐药性,所得到的687株病原菌药敏结果依据美国临床实验室标准化研究所2011年判断标准,采用WHONET5.6统计分析数据.结果 临床分离687株菌,革兰阴性杆菌占55.02%,革兰阳性球菌占39.88%,真菌占5.09%.感染类型以呼吸道（63%）和泌尿道（23%）感染最为多见.药敏结果显示肠杆菌科的大肠埃希菌对亚胺培南、美洛培南、阿米卡星、哌拉西林/他唑巴坦等抗生素的耐药率较低.铜绿假单胞菌对上述碳青霉烯类抗生素的耐药率分别是18.5%和21.9%.金黄色葡萄球菌和凝固酶阴性葡萄球菌中耐甲氧西林株分别占69.2%和75%.葡萄球菌对万古霉素、利奈唑胺、喹奴普汀/达福普汀等具有高度的敏感性.白假丝酵母菌对常用的真菌药物敏感性较高.结论 医院临床感染的病原微生物种类以革兰阴性杆菌为主,其中大肠埃希菌和铜绿假单胞菌分离率较高.引起感染的病原菌对常规应用的抗菌药物耐药性日趋严重,医院应加强耐药性检测,以指导临床合理用药,降低医院感染.
Objective To investigate the distribution and antibiotic resistances profile of clinical isolates from 2010 to 2012 in Affiliated Mental Health Cemter of Shanghai Jiaotong University Medicine School,so as to promote the rational use of anti-bacterial drugs. Methods The microorganisms were isolated from clinical samples according to the guides of standard opera-tion protocol. Identification and antibiotic sensitivity tests were done by VITEK2 system. The result of antibiotic resistance of the 687 clinical isolates was according to 2011 CLSI standards. WHONETS. 6 statistic software was used to analyse the date. Results Of the 687 clinical isolates, gram-negative rods, gram positive coccus and fungus accounted for 55.02%, 39.88 % and 5.09% respectively. Mainly caused respiratory tract （63 %）or urinary tract（23%） infection. The result of anti-biotic resistance showed that the common Enterobacteriaceae spp such an E. coli was highly sensitive to Imipenem,Mero-penem,Amikacin, Piperacillin-tazobactam. However, 18. 5% and 21.9% of P aeruginosa was resistant to the above carbap-enems. About 69.2 % of Staphylococcus aureus isolates were identified as methocillin-resistant Staphylococcus,75% of co-agulase negative Staphylococcus （CNS） isolates were methocillin-resistant. Staphylococcus spp was highly sensitive to Van- comycin,Linezolid,Quinupristin-dalfopristin. Candidat albicans were totally sensitive to the common antifungus drug. Con-clusion The major clinical pathogenic microorganisms in hospital were Gram negative rods with the high isolating rates of E. coli and Paeruginosa. Especially becteria resisted to conventional used anti-bacterial agents is becoming more and more serious, the hospital should enhance the resistance surveillance of the antifungal agents so as to guide their rational use in clinical practice and, reduce nosocomial infection.
出处
《现代检验医学杂志》
CAS
2013年第5期132-134,137,共4页
Journal of Modern Laboratory Medicine
关键词
耐药性
抗菌药物
病原菌
医院感染
resistance
anti-bacterial agents
pathogenic bacteria
nosocomial infection
