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目的了解近期医院临床分离病原菌的构成及其对抗菌药物的耐药性情况,指导临床合理应用抗菌药物。方法采用细菌分离鉴定和药敏试验方法,对某医院2013年度全年病人送检标本进行了检测与结果分析。结果 2013年度从该医院送检的病人标本中共分离出病原菌3 166株,包括革兰阴性菌2 247株(71%),革兰阳性菌919株(29%)。构成比居前三位的病原菌依次为大肠埃希菌(22.0%)、鲍曼不动杆菌(11.2%)和肺炎克雷伯菌(9.8%)。病原菌主要分离自呼吸道标本(54.5%)、尿液标本(17.6%)和各种分泌物标本(10.3%)。铜绿假单胞菌对碳青霉烯类和氨基糖苷类耐药率高达75%以上,但其对3代头孢菌素具有较好的敏感性。金黄色葡萄球菌对β内酰胺类和大环内酯类耐药率均达75%以上,对喹诺酮类和氨基糖苷类耐药率也达到50%以上。结论该医院临床分离的病原菌以革兰阴性杆菌为主,部分病原菌已经对碳青霉烯类等抗菌药物产生较高的耐药性,提示临床密切关注。
Objective To understand the composition of clinical isolates of clinical isolates from hospitals and their resistance to antibacterials in the near future and to guide the rational use of antibacterials in clinics. Methods The method of bacterial isolation and identification and drug susceptibility testing were used to test and analyze the results of patient examination in 2013 in a hospital. Results A total of 3,166 pathogens were isolated from patients in the hospital in 2013, including 2 247 (71%) Gram-negative bacteria and 919 (29%) Gram-positive bacteria. The top three pathogenic bacteria were Escherichia coli (22.0%), Acinetobacter baumannii (11.2%) and Klebsiella pneumoniae (9.8%). Pathogenic bacteria were mainly isolated from respiratory specimens (54.5%), urine specimens (17.6%) and various secretions specimens (10.3%). Pseudomonas aeruginosa carbapenem and aminoglycoside resistance rates as high as 75%, but its on the third generation cephalosporins have good sensitivity. Staphylococcus aureus resistance to β-lactams and macrolides were more than 75%, quinolones and aminoglycoside resistance rate reached more than 50%. Conclusions The pathogenic bacteria isolated from the hospital are mainly Gram-negative bacilli. Some pathogens have already developed high resistance to carbapenems and other antibiotics, which is of great concern to the clinicians.