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目的了解重庆市荣昌区中医院临床常见病原菌的分布及耐药情况,为临床合理用药提供参考。方法收集重庆市荣昌区中医院2013年9月—2015年9月检验科分离的病原菌及药敏试验结果进行统计分析。结果共分离出病原菌600株,其中革兰阴性菌428株,占71.33%;革兰阳性菌172株,占28.67%。标本主要来自痰液,构成比为75.08%。革兰阳性菌中,葡萄球菌检出率高且耐药较严重,金黄色葡萄球菌敏感的药物有万古霉素、多西环素、阿米卡星和呋喃妥因。未发现耐万古霉素的葡萄球菌。革兰阴性菌中肺炎克雷伯菌对氨苄西林耐药率为100.0%,对其他均敏感;大肠埃希菌对头孢哌酮/舒巴坦钠、哌拉西林/他唑巴坦、亚胺培南较敏感。铜绿假单胞菌、洋葱伯克霍尔德菌和嗜麦芽寡养单胞菌呈现出多重耐药性,对常见抗菌药物均有不同程度的耐药;鲍曼不动杆菌对头孢哌酮/舒巴坦钠、哌拉西林/他唑巴坦、美罗培南、复方新诺明、米诺环素敏感。结论重庆市荣昌区中医院常见病原菌耐药严重,临床应重视病原菌检查,同时加强监管,以降低细菌耐药性。
Objective To understand the distribution and drug resistance of common pathogens in Rongchang District Hospital of Chongqing Municipality and provide references for clinical rational use of drugs. Methods The pathogenic bacteria and drug susceptibility test results collected from Rongchang District Traditional Chinese Medicine Hospital of Chongqing from September 2013 to September 2015 were collected for statistical analysis. Results A total of 600 pathogens were isolated, of which 428 were Gram-negative bacteria, accounting for 71.33%; 172 were Gram-positive bacteria, accounting for 28.67%. Specimens mainly from sputum, the composition ratio of 75.08%. Gram-positive bacteria, the detection rate of staphylococcus and more resistant, Staphylococcus aureus sensitive drugs are vancomycin, doxycycline, amikacin and nitrofurantoin. No vancomycin-resistant staphylococci were found. Gram-negative bacteria Klebsiella pneumoniae to ampicillin resistance rate was 100.0%, were sensitive to other; Escherichia coli cefoperazone / sulbactam sodium, piperacillin / tazobactam, imine Pei Nan is more sensitive. Pseudomonas aeruginosa, Burkholderia cepacia, and Stenotrophomonas maltophilia showed multi-drug resistance and resistance to common antimicrobial drugs to varying degrees. Acinetobacter baumannii did not respond to cefoperazone / Sulbactam sodium, piperacillin / tazobactam, meropenem, cotrimoxazole, minocycline. Conclusions The common pathogens in Rongchang District Hospital of Chongqing Municipality are seriously drug-resistant. Clinicians should pay more attention to pathogen detection and strengthen supervision so as to reduce bacterial resistance.