2008—2010年某院临床主要病原菌分布及耐药性变迁
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任冬梅

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R969.3

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2011年焦作市科技局基金课题(焦科[2011]92-9)


Distribution and antimicrobial resistance of major clinical pathogens isolated from 2008 to 2010
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    摘要:

    目的探讨某院临床近年主要病原菌分布及耐药性,为临床合理用药提供依据。方法收集该院2008年1月—2010年12月分离自门诊及住院患者的病原菌资料,对其构成及耐药性作统计分析。结果共分离病原菌7 008株,其中革兰阴性菌3 961株(56.52%),革兰阳性菌1 582株(22.57%),真菌1 465株(20.91%);居前3位的病原菌依次为白假丝酵母菌(1 015株,15.00%)、铜绿假单胞菌(906株,12.93%)、大肠埃希菌(874株,12.47%)。2008—2010年,金黄色葡萄球菌中耐甲氧西林株总检出率为85.07%(678/797),凝固酶阴性葡萄球菌中耐甲氧西林株总检出率为73.17%(150/205);大肠埃希菌和肺炎克雷伯菌产超广谱β内酰胺酶株的总检出率分别为64.19%(561/874)、46.31%(301/650)。金黄色葡萄球菌对万古霉素、替考拉宁敏感,对复方磺胺甲口恶唑敏感率(68.42%~74.51%)较高,对其余抗菌药物敏感率均<30%;凝固酶阴性葡萄球菌对万古霉素、替考拉宁敏感;大肠埃希菌和肺炎克雷伯菌对亚胺培南和美罗培南敏感率(95.52%~100.00%)最高,大肠埃希菌对第三代头孢菌素头孢噻肟、头孢曲松、头孢哌酮和氟喹诺酮类环丙沙星、左氧氟沙星敏感率均<30%。3年铜绿假单胞菌对头孢他啶和美罗培南的敏感率均较高,分别为60.31%~85.83%、59.38%~73.23%。结论该院分离的主要病原菌对常用抗菌药物耐药性普遍较高,应加强监控,合理使用抗菌药物,有效预防和控制医院感染的发生。

    Abstract:

    ObjectiveTo investigate the distribution and antimicrobial resistance of pathogens from patients in a hospital ,and provide basis for rational use of antimicrobial agents.MethodsData about bacterial strains isolated from inpatients and outpatients in a hospital from January 2008 to December 2010 were collected , distribution and antimicrobial resistance of pathogens were analyzed .ResultsA total of 7 008 bacterial strains were isolated, 3 961(56.52%) isolates were gramnegative bacteria , 1 582 (22.57%) were grampositive bacteria, and 1 465(20.91%) were fungi; the top three pathogens were Candida albicans (1 015 isolates, 15.00%) ,Pseudomonas aeruginosa(906 isolates, 12.93%),Escherichia coli(874 isolates, 12.47%). Methicillinresistant Staphylococcus aureus (MRSA) accounted for 85.07%(678/797) of all Staphylococcus aureus, methicillinresistant coagulasenegative Staphylococcus (MRCNS) accounted for 73.17%(150/205) of all CNS; the isolation rate of extendedspectrum βlactamase (ESBLS)producing Escherichia coli and Klebsiella pneumoniae was 64.19%(561/874) and 46.31%(301/650) respectively. Staphylococcus aureus isolates were sensitive to vancomycin and teicoplanin, the resistant rate to sulfamethoxazole/trimethoprim was 68.42%-74.51%, the resistant rate to the other agents were all <30%; isolates of CNS were sensitive to vancomycin and teicoplanin; Escherichia coli and Klebsiella pneumoniae had highest sensitive rate to imipenem and meropenem (95.52%-100.00%), the resistant rate of Escherichia coli to cefotaxime, ceftriaxone,cefoperazone , ciprofloxacin, and levofloxacin were all <30%. Pseudomonas aeruginosa had relative higher resistant rate to ceftazidime (60.31%-85.83%) and meropenem (59.38%-73.23%).ConclusionAntimicrobial resistance of major pathogens isolated from patients in this hospital were generally high . It should pay more attention to the monitoring of multidrug resistant strains, antimicrobial agents should be used rationally.

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李德保 ,任冬梅,田春梅.2008—2010年某院临床主要病原菌分布及耐药性变迁[J]. 中国感染控制杂志,2013,12(1):54-58. DOI:10.3969/j. issn.1671-9638.2013.
LI Debao, REN Dongmei, TIAN Chunmei. Distribution and antimicrobial resistance of major clinical pathogens isolated from 2008 to 2010[J]. Chin J Infect Control, 2013,12(1):54-58. DOI:10.3969/j. issn.1671-9638.2013.

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  • 收稿日期:2012-04-22
  • 最后修改日期:2012-07-02
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  • 在线发布日期: 2013-01-31
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