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目的分析2015年广东省中医院临床分离的病原菌的分布及其耐药谱,为临床抗菌药物的使用和医院感染的监控提供依据。方法总结分析2015年临床分离的病原菌的分布及耐药情况,并采用K-B纸片扩散法对主要的病原菌进行耐药性分析,数据统计采用SPSS19.0软件进行统计分析。结果 2015年共分离3 558株病原菌,其中革兰阴性杆菌检出2 617株,占73.6%;革兰阳性球菌检出941株,占26.4%。病原菌检出率高的病原菌前10位依序是大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌、金黄色葡萄球菌和粪肠球菌。革兰阴性杆菌对厄他培南、阿米卡星和哌拉西林/他唑巴坦的耐药性较低,而鲍曼不动杆菌的耐药率普遍较高;革兰阳性球菌则对头孢曲松、头孢呋辛钠、青霉素G和克林霉素的耐药性较高,未发现对万古霉素、利奈唑胺、替加环素耐药的金黄色葡萄球菌和粪肠球菌。结论病原菌的分布及其耐药谱分析的结果对医院感染的监控和对指导临床改变抗菌药物的使用习惯以降低细菌的耐药性都有着积极的意义。
Objective To analyze the distribution and drug resistance spectrum of pathogenic bacteria in clinics isolated in Guangdong Provincial Hospital of Traditional Chinese Medicine from 2015 to provide evidences for clinical use of antibacterials and monitoring of nosocomial infections. Methods The distribution of clinical isolates and drug resistance in 2015 were analyzed. The drug resistance of major pathogenic bacteria was analyzed by K-B disk diffusion method. The data were statistically analyzed by SPSS19.0 software. Results A total of 3 558 pathogens were isolated in 2015, of which 2 617 were Gram-negative bacilli (73.6%), 941 were Gram-positive cocci (26.4%). Pathogen high detection rate of the top 10 pathogens are Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Enterococcus faecalis. Gram-negative bacilli were less resistant to ertapenem, amikacin and piperacillin / tazobactam, whereas Acinetobacter baumannii was generally more resistant; Gram-positive cocci Ceftriaxone, cefuroxime sodium, penicillin G and clindamycin higher resistance, did not find vancomycin, linezolid, tigecycline-resistant Staphylococcus aureus and Enterococcus faecalis. Conclusion The distribution of pathogenic bacteria and the results of their drug resistance spectrum analysis have a positive effect on the monitoring of nosocomial infections and on changing the habit of using antibiotics to reduce the drug resistance of bacteria.