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目的对医院临床分离细菌构成及耐药情况进行监测分析,为临床合理使用抗菌药物提供可靠依据。方法回顾性分析2014年1月1日-2015年12月31日医院临床送检标本资料,统计分离出的病原菌分布情况及药物敏感试验结果。结果共收集临床分离获得的非重复细菌菌株1994株,革兰阳性菌823株(41.3%),革兰阴性菌1171(58.7%),革兰氏阴性菌主要是流感嗜血杆菌、卡他莫拉菌、大肠埃希菌、肺炎克雷伯菌。革兰氏阳性菌中排名前3位的是肺炎链球菌、金黄色葡萄球菌和表皮葡萄球菌。耐甲氧西林葡萄球菌(MRSA)检出率为23.6%,氨氨基糖苷类高水平耐药肠球菌(HLAR)检出率为13.6%,产超广谱β-内酰胺酶(ESBLs)大肠埃希菌、肺炎克雷伯菌检出率分别为13.8%、7.3%,未分离出耐万古霉素肠球菌(VRE)以及多重耐药鲍曼不动杆菌。结论建议临床医师严格把握抗菌药物使用指征,综合评估患者病情和临床表现,根据细菌耐药监测结果,合理选择抗菌药物,从而减缓细菌的耐药趋势。
Objective To monitor and analyze the composition and drug resistance of clinically isolated bacteria in hospitals and provide a reliable basis for the rational use of antibacterials in clinical practice. Methods Retrospective analysis of clinical laboratory specimens from January 1, 2014 to December 31, 2015, the distribution of pathogenic bacteria and drug susceptibility test results were statistically analyzed. Results A total of 1994 strains of non-repetitive bacterial strains, 823 strains of Gram-positive bacteria (41.3%) and 1171 (58.7%) of gram-negative bacteria were collected. Gram-negative bacteria were mainly Haemophilus influenzae, Streptococcus, Escherichia coli, Klebsiella pneumoniae. The top three Gram-positive bacteria are Streptococcus pneumoniae, Staphylococcus aureus and Staphylococcus epidermidis. The detection rate of methicillin-resistant Staphylococcus aureus (MRSA) was 23.6%, the detection rate of high-level aminoglycoside resistant enterococci (HLAR) was 13.6%, ESBLs-producing Escherichia coli The detection rates of Klebsiella pneumoniae and Klebsiella pneumoniae were 13.8% and 7.3%, respectively, and vancomycin-resistant Enterococcus (VRE) and Acinetobacter baumannii were not isolated. Conclusions It is suggested that clinicians strictly grasp the indications of antimicrobial use, evaluate the patients’ condition and clinical manifestations comprehensively, and select appropriate antimicrobial agents according to the results of bacterial drug resistance monitoring so as to slow down the trend of drug resistance in bacteria.