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。

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.