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目的分析本院2014年临床检出病原菌的分布及主要病原菌耐药情况,为临床合理用药和控制医院感染提供可靠的依据。方法采用法国梅里埃ATB-New微生物鉴定仪对2014年全年临床送检的各类标本中分离的1 169株病原菌进行鉴定及药敏试验。结果检出的病原菌以革兰阴性杆菌为主,占58.7%;革兰阳性球菌次之,占31.2%,真菌占10.1%。病原菌顺序依次为大肠埃希菌、肺炎克雷伯菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌、阴沟肠杆菌、肠球菌属。肠杆菌科细菌对阿莫西林耐药率都达到90%以上,对哌拉西林、替卡西林、头孢呋辛耐药率达70%以上;铜绿假单胞菌对头孢噻肟、替卡西林、环丙沙星耐药率达60%以上;鲍曼不动杆菌耐药率较高,对头孢噻肟、哌拉西林、替卡西林、环丙沙星、庆大霉素耐药率达70%以上;金黄色葡萄球菌、凝固酶阴性葡萄球菌对青霉素、红霉素耐药率达90%以上。结论加强对病原菌分布及耐药性监测,及时指导临床合理应用抗生素,控制或降低院内感染的发生及多重耐药菌产生。
Objective To analyze the distribution of clinical pathogens and drug resistance of major pathogenic bacteria in our hospital in 2014, and provide a reliable basis for rational clinical use and control of nosocomial infections. Methods A total of 1,169 strains of pathogens isolated from various clinical samples in 2014 were identified and susceptible tested by ATB-New Microbial Identification Instrument. Results Gram-negative bacilli were the main pathogens detected, accounting for 58.7%. Gram-positive cocci was the second, accounting for 31.2% and fungi accounting for 10.1%. The order of pathogen was Escherichia coli, Klebsiella pneumoniae, coagulase-negative staphylococcus, Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Enterobacter cloacae and Enterococcus. Enterobacteriaceae resistant to amoxicillin were more than 90%, resistant to piperacillin, ticarcillin, cefuroxime more than 70%; Pseudomonas aeruginosa cefotaxime, ticarcillin , Ciprofloxacin resistance rate of more than 60%; Acinetobacter baumannii higher rate of resistance to cefotaxime, piperacillin, ticarcillin, ciprofloxacin, gentamicin resistance rates up to 70%; Staphylococcus aureus, coagulase-negative Staphylococcus aureus, erythromycin resistance rate of more than 90%. Conclusion To strengthen the distribution of pathogens and drug resistance monitoring, promptly guide the rational use of antibiotics in clinical practice, control or reduce the incidence of nosocomial infections and multi-drug resistant bacteria.