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目的研究医院临床分离病原菌的构成及其耐药情况,为合理使用抗菌药物及耐药菌预防控制提供依据。方法采用细菌检验技术,对某驻军医院2014年度住院患者送检标本进行检验与结果分析。结果 2014年度该医院从住院患者送检标本中共分离病原菌2 670株,其中多重耐药菌占病原菌总数的38.02%;革兰阴性菌、革兰阳性菌和真菌检出构成比分别为73.6%、18.2%和13.4%。病原菌中居前5位的依次是铜绿假单胞菌,肺炎克雷伯菌,鲍曼不动杆菌,大肠埃希菌和白色念珠菌。分离率居首位的铜绿假单胞菌对头孢类耐药率达到75%以上,对喹诺酮类、氨基糖苷类和β-内酰胺类较敏感;肺炎克雷伯菌对β-内酰胺酶抑制类及氨基糖苷类抗菌药物较敏感;金黄色葡萄球菌对青霉素耐药率达100%,MRSA及肠球菌中均检出耐万古霉素株。结论该医院临床分离病原菌中以革兰阴性菌为主,多重耐药菌比例较高,对头孢类抗菌药物耐药严重。
Objective To study the composition of clinical isolates of pathogenic bacteria in hospital and their drug resistance, and to provide basis for rational use of antibacterials and prevention and control of drug-resistant bacteria. Methods The bacterial test technique was used to test and analyze the specimens of inpatients in a garrison hospital in 2014. Results In 2014, 2 670 pathogens were isolated from hospitalized patients and 38.02% of them were multi-drug resistant strains. The proportions of Gram-negative bacteria, Gram-positive bacteria and fungi were 73.6% 18.2% and 13.4%. Among the top five pathogens, there were Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli and Candida albicans. Pseudomonas aeruginosa with the highest isolation rate reached more than 75% of the cephalosporins and was more sensitive to quinolones, aminoglycosides and β-lactams; Klebsiella pneumoniae inhibited β-lactamase Class and aminoglycoside antibacterial drugs more sensitive; Staphylococcus aureus resistant to penicillin rate of 100%, MRSA and enterococci were detected vancomycin-resistant strains. Conclusions Gram-negative bacteria are the main pathogens isolated from clinical isolates in this hospital. The proportion of multi-resistant bacteria is high, and the resistance to cephalosporins is serious.