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目的:调查2015-01-2016-06住院患者送检标本检出的主要细菌分布及耐药性,为临床合理用药及控制感染提供依据。方法:对医院临床送检标本分离的常见细菌分布及药敏结果进行回顾性分析。结果:我院共分离细菌13 243株,居前5位的细菌为大肠埃希菌、鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌,分别占16.24%、13.95%、9.84%、9.65%、6.87%。大肠埃希菌对喹诺酮类耐药率为59.9%~74.2%,对头孢唑啉耐药率高达100%,2015年美罗培南的耐药率为0.6%~1.8%,2016年未发现对美罗培南耐药的大肠埃希菌。鲍曼不动杆菌对替加环素耐药率为23.6%~26.2%,对头孢类、碳青霉烯类的耐药率最高达88.8%。肺炎克雷伯菌对哌拉西林/他唑巴坦、碳青霉烯类、阿米卡星的耐药率为0.6%~13.4%。铜绿假单胞菌对碳青霉烯类、头孢哌酮/舒巴坦、环丙沙星的耐药率高达50%。金黄色葡萄球菌对苯唑西林的耐药率为40.2%~61.6%,对利奈唑胺的耐药率为0~0.9%,未发现对万古霉素耐药的菌株。结论:临床医师应及时掌握病原菌的耐药性及分布,以提高经验性治疗的准确性,减少细菌耐药性的发生,降低临床病死率。
Objective: To investigate the distribution and drug resistance of major bacteria detected in hospitalized patients from January 2015 to June 2016, providing the basis for rational clinical use and infection control. Methods: A retrospective analysis was made on the distribution of common bacteria and drug susceptibility results of clinical isolates from clinical specimens. Results: A total of 13 243 bacterial strains were isolated from our hospital. The top 5 bacteria were Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus, accounting for 16.24% , 13.95%, 9.84%, 9.65%, 6.87%. Escherichia coli quinolones resistance rate was 59.9% ~ 74.2%, cefazolin resistance rate as high as 100%, 2015 meropenem resistance rate was 0.6% ~ 1.8% in 2016 did not find the meropenem Resistant Escherichia coli. Acinetobacter baumanii resistance rate of tigecycline was 23.6% ~ 26.2%, cephalosporins, carbapenem resistance rates up to 88.8%. Klebsiella pneumoniae to piperacillin / tazobactam, carbapenems, amikacin resistance rate of 0.6% to 13.4%. Pseudomonas aeruginosa carbapenems, cefoperazone / sulbactam, ciprofloxacin resistance rates as high as 50%. Staphylococcus aureus resistance rate to oxacillin was 40.2% ~ 61.6%, linezolid resistance rate was 0 ~ 0.9%, no vancomycin resistant strains were found. Conclusion: Clinicians should grasp the drug resistance and distribution of pathogens in time to improve the accuracy of empirical treatment, reduce the incidence of bacterial resistance and reduce the clinical mortality.