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外科研究与新技术（中英文）

外科研究与新技术 ›› 2017, Vol. 6 ›› Issue (4): 271-275.doi: 10.3969/j.issn.2095-378X.2017.04.013

• 论著 • 上一篇    下一篇

3 302株临床病原菌的分布及耐药性分析

侯伟伟, 江涟, 李冬   

  1. 同济大学附属同济医院检验科,上海 200065
  • 收稿日期:2017-09-20 发布日期:2017-12-28
  • 通讯作者: 李 冬,电子邮箱:186ld@163.com
  • 作者简介:侯伟伟(1983—),女,主管技师,从事微生物技术

Distribution and antimicrobial resistance of 3302 pathogenic bacteria isolated from clinical samples

HOU Weiwei, JIANG Lian, LI Dong   

  1. Department of Clinical Laboratory,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China
  • Received:2017-09-20 Published:2017-12-28

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摘要： 目的 了解临床病原菌的分布及耐药情况,为临床医师合理应用抗生素提供依据。方法 采用VITEK2 Compact自动微生物鉴定药敏仪进行细菌鉴定,WHONET 5.6软件回顾性分析3 302株临床分离病原菌。结果 临床分离出病原菌3 302株。其中,革兰阴性菌占73%(2 417/3 302),革兰阳性球菌占27%(885/3 302);位列前5位的病原菌分别是大肠埃希菌(24%)、肺炎克雷伯菌(18%)、铜绿假单胞菌(10%)、金黄色葡萄球菌(9%)和鲍曼不动杆菌(9%)。在革兰阴性菌中,大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌的超广谱β-内酰胺酶(ESBLs)检出率分别为50%、16.2%和30.2%;鲍曼不动杆菌和肺炎克雷伯菌对碳青霉烯类抗生素耐药比较严重。革兰阳性菌中,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为48.2%;MRSA对抗生素的耐药率普遍高于甲氧西林敏感金黄色葡萄球菌(MSSA)。结论 临床细菌耐药依然严重,应加强防范多重耐药菌感染对临床造成的危害。耐药监测对临床感染控制和抗生素合理应用具有重要意义。

关键词: 细菌, 耐药性, 细菌耐药性监测

Abstract: Objective To understand the distribution and antimicrobial resistance of clinical bacteria,and provide scientific evidence for clinically reasonable use of antibiotics.Methods VITEK-2 Compact automated microbial identification system was used to identify clinical strains.WHONET 5.6 software was used to analyze 3 302 pathogenic bacteria isolated from clinical samples.Results A total of 3 302 strains of pathegenic bacteria were isolated.Of them,the prevalence of gram-negative bacteria was 73% (2 417/3 302) and that of gram-positive bacteria was 27% (885/3 302).The top five isolates were Escherichia coli (24%),Klebsiella pneumoniae (18%),Pseudomonas aeruginosa (10%),Staphylococcus aureus (9%),and Acinetobacter baumannii (9%).For Gram-negative bacteria,ESBLs-producing strains accounted for 50% in Escherichia coli,16.2% in Klebsiella,and 30.2% in Proteus mirabilis.The carbapenem-resistace of Acinetobacter baumannii and Klebsiella pneumonia was serious.For gram-positive bacteria,the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 48.2%.The resistance rate of MRSA was higher than that of methicillin-sensitive Staphylococcus aureus (MSSA).Conclusion The bacterial drug-resistance is still a serious issue in clinical setting.Thus,more attention should be paid to multi-drug resistant pathogenic bacteria.Surveillance of bacterial resistance is of great significance to clinical infection control and rational drug use.

Key words: Bacteria, Drug-resistance, Bacterial resistance surveillance

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