【摘要】 目的了解医院感染病原菌的分离率、临床分布及其耐药性变化趋势,指导临床合理用药和控制医院感染。方法分析2006年1月~2008年12月临床患者的标本,采用WHONET5.4软件进行统计分析。结果 3年共分离病原菌3311株,分离率为40.1%,科室分布以呼吸内科最多,年龄分布以>60岁老年患者为多;检出的病原菌中,革兰阴性杆菌占首位64.4%,其次是革兰阳性球菌占20.1%,真菌位居第3位占15.5%;病原菌感染位居前几位的依次是大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、白色假丝酵母菌;耐药菌株检测发现MRSA检出率为26.75%;革兰阳性球菌对万古霉素、替考拉宁的敏感性最好;大肠埃希菌、肺炎克雷伯菌中产ESBLs的菌株检出率分别为40.1%和16.4%;革兰阴性杆菌对亚胺培南、美罗培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦有较高敏感性,但大肠埃希菌对三代头孢菌素的耐药率逐年增加(P<0.05),产ESBLs菌株数量也逐年增加(P<0.05)。结论病原菌的多药耐药是医院目前面临的重要问题,在临床上应改进治疗手段,重视细菌培养和合理用药,尽量减少病原菌耐药性的发生。更多还原

【Abstract】 OBJECTIVE To study the clinical distribution and drug resistance characteristics of pathogens from nosocomial infection cases to provide the gist for clinical therapy and control the direction of nosocomial infection.METHODS Gathering samples from impatients in our hospital between Jan 2006 to Dec 2008,we applied the software of WHONET 5.4 for analyzing the cases.RESULTS During the three-year infection surveillance,3311 strains of pathogens were isolated in our hospital,and the clinical isolation rate was 40.1%.The highest infection rate was in Department of Respiratory Disease,and among over 60-year-old sufferers.Among 3311 strains of pathogens from these samples,2132 strains were G-bacilli(64.4%),665 strains were G+ bacteria(20.1%) and 514 strains were fungi(15.5%).The most common species among 3311 pathogen strains were Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,Staphylococcus aureus and Candida albicans.The survey of drug resistance strains performed that the detecting rate of MRSA was 26.75%,and the VRSA strains were not detected.Drug resistance results showed that the susceptibility rate of G+ bacteria to vancomycin and minocycline both was the highest.The incidences of E.coli and K.pneumoniae isolates producing extended spectrum beta-lactamases(ESBLs)were 40.1% and 16.4%.The susceptibility rate of G-bacilli to imipenem,meropenem,piperacillin/tazobactam,and cefoperazone/sulbactam was much hiher,the trend of ESBLs prodoing E.coli was increasing every year(P<0.05),so as the resistance to the third generation cephalosporin(P<0.05).CONCLUSIONS Multiple antibacterial resistance is a important question faced by our hospital,and we should pay attention to promote the rational use of antimicrobial agents and take effective measures to reduce resistance rates of bacteria.更多还原