论文部分内容阅读
目的:分析2013~2015年某院临床分离菌的分布和耐药特征,为医院感染防控和抗菌药物合理使用提供参考依据。方法:采用微生物常规检测方法对分离菌株进行药敏试验,通过生物梅里埃ATB 1.22软件对药物敏感实验进行分析。根据CLSI 2014年标准判定药敏结果。结果:2013~2015年送检标本数为18 421份,从中分离出各种病原菌共3 744株,总阳性率为20.32%。分离鉴定前5位的致病菌分别为大肠埃希菌(967株,44.34%)、鲍曼不动杆菌(323株,14.81%)、肺炎克雷伯菌(312株,14.31%)、金黄色葡萄球菌(297株,13.62%)、铜绿假单胞菌(282株,12.92%)。除肺炎克雷伯菌对阿莫西林天然耐药外,大肠埃希菌对哌拉西林耐药率超过75%,肺炎克雷伯菌对哌拉西林/他唑巴坦敏感率则维持在90%以上。鲍曼不动杆菌、铜绿假单胞菌对临床常用抗菌药物敏感性基本维持在40%以下,整体耐药水平较高。MRSA对呋喃妥因、米诺环素、奎奴普汀–达福普汀以及糖肽类药物(如替考拉宁、万古霉素)敏感。结论:医院应加强细菌耐药监测,并对结果进行及时追踪,为临床合理选择用药提供参考依据。
Objective: To analyze the distribution and drug resistance characteristics of clinical isolates in a hospital from 2013 to 2015, and provide references for the prevention and control of nosocomial infections and rational use of antimicrobial agents. Methods: The antibiotic susceptibility test of the isolates was carried out by the routine test of microorganisms, and the drug susceptibility test was analyzed by the bioMérieux ATB 1.22 software. Susceptibility results based on CLSI 2014 criteria. Results: A total of 18 421 specimens were collected from 2013 to 2015. A total of 3 744 strains of pathogens were isolated. The total positive rate was 20.32%. The first 5 isolates were identified as Escherichia coli (967 strains, 44.34%), Acinetobacter baumannii (323 strains, 14.81%), Klebsiella pneumoniae (312 strains, 14.31%), Staphylococcus aureus (297 strains, 13.62%), Pseudomonas aeruginosa (282 strains, 12.92%). In addition to Klebsiella pneumoniae amoxicillin natural resistance, Escherichia coli piperacillin resistance rate of more than 75%, Klebsiella pneumoniae piperacillin / tazobactam sensitivity was maintained at 90 %the above. Acinetobacter baumannii, Pseudomonas aeruginosa commonly used in clinical antibacterial drug sensitivity remained below 40%, a higher overall level of resistance. MRSA is sensitive to nitrofurantoin, minocycline, quinuptin-darfopristin, and glycopeptide drugs such as teicoplanin and vancomycin. Conclusion: The hospital should strengthen the monitoring of bacterial resistance and timely follow-up of the results, providing a reference for clinical rational choice of medication.