实用医院临床杂志
實用醫院臨床雜誌
실용의원림상잡지
Practical Journal of Clinical Medicine
2015年
6期
87-89
,共3页
奉婷%唐荣珍%喻华%杜恒健%蔡敏泓
奉婷%唐榮珍%喻華%杜恆健%蔡敏泓
봉정%당영진%유화%두항건%채민홍
病原菌%细菌耐药性%抗菌药%药敏试验
病原菌%細菌耐藥性%抗菌藥%藥敏試驗
병원균%세균내약성%항균약%약민시험
Pathogens%Bacterial resistance%Antimicrobial agent%Antibiotic susceptibility testing
目的：了解四川省人民医院老年科临床送检标本病原菌的分布特点及耐药特点，指导临床合理用药。方法对2012年四川省人民医院老年科临床分离标本的来源、病原菌分布及耐药性等资料进行统计分析。结果2598株病原菌中，革兰阴性菌株占78.91％，革兰阳性菌株占21.09％。分离前五位分别是铜绿假单胞菌、大肠埃希菌、克雷伯氏菌属、不动杆菌属和柠檬酸杆菌属。革兰阴性菌中，大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶（ ESBLs ）株分别为55.86％和35.4％，肠杆菌科细菌对碳青霉烯类抗生素的耐药性＜3.8％。铜绿假单胞菌对亚胺培南耐药率为66.96％，对阿米卡星、哌拉西林／他唑巴坦耐药率较低，分别为4.16％和13.69％。鲍曼不动杆菌对亚胺培南耐药率为58.74％。革兰阳性菌中，耐甲氧西林金黄色葡萄球菌（ MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（ MRCNS）检出率分别为65.82％和79.23％。肠球菌中粪肠球菌和屎肠球菌分别占16.67％和83.33％。发现2株耐万古霉素的MRCNS和2株耐万古霉素肠球菌。结论我院老年科患者感染以呼吸道感染为主，细菌耐药性日趋严重，碳青霉烯类抗生素对肠杆菌科细菌仍有较高的抗菌活性。
目的：瞭解四川省人民醫院老年科臨床送檢標本病原菌的分佈特點及耐藥特點，指導臨床閤理用藥。方法對2012年四川省人民醫院老年科臨床分離標本的來源、病原菌分佈及耐藥性等資料進行統計分析。結果2598株病原菌中，革蘭陰性菌株佔78.91％，革蘭暘性菌株佔21.09％。分離前五位分彆是銅綠假單胞菌、大腸埃希菌、剋雷伯氏菌屬、不動桿菌屬和檸檬痠桿菌屬。革蘭陰性菌中，大腸埃希菌和肺炎剋雷伯菌產超廣譜β-內酰胺酶（ ESBLs ）株分彆為55.86％和35.4％，腸桿菌科細菌對碳青黴烯類抗生素的耐藥性＜3.8％。銅綠假單胞菌對亞胺培南耐藥率為66.96％，對阿米卡星、哌拉西林／他唑巴坦耐藥率較低，分彆為4.16％和13.69％。鮑曼不動桿菌對亞胺培南耐藥率為58.74％。革蘭暘性菌中，耐甲氧西林金黃色葡萄毬菌（ MRSA）和耐甲氧西林凝固酶陰性葡萄毬菌（ MRCNS）檢齣率分彆為65.82％和79.23％。腸毬菌中糞腸毬菌和屎腸毬菌分彆佔16.67％和83.33％。髮現2株耐萬古黴素的MRCNS和2株耐萬古黴素腸毬菌。結論我院老年科患者感染以呼吸道感染為主，細菌耐藥性日趨嚴重，碳青黴烯類抗生素對腸桿菌科細菌仍有較高的抗菌活性。
목적：료해사천성인민의원노년과림상송검표본병원균적분포특점급내약특점，지도림상합리용약。방법대2012년사천성인민의원노년과림상분리표본적래원、병원균분포급내약성등자료진행통계분석。결과2598주병원균중，혁란음성균주점78.91％，혁란양성균주점21.09％。분리전오위분별시동록가단포균、대장애희균、극뢰백씨균속、불동간균속화저몽산간균속。혁란음성균중，대장애희균화폐염극뢰백균산초엄보β-내선알매（ ESBLs ）주분별위55.86％화35.4％，장간균과세균대탄청매희류항생소적내약성＜3.8％。동록가단포균대아알배남내약솔위66.96％，대아미잡성、고랍서림／타서파탄내약솔교저，분별위4.16％화13.69％。포만불동간균대아알배남내약솔위58.74％。혁란양성균중，내갑양서림금황색포도구균（ MRSA）화내갑양서림응고매음성포도구균（ MRCNS）검출솔분별위65.82％화79.23％。장구균중분장구균화시장구균분별점16.67％화83.33％。발현2주내만고매소적MRCNS화2주내만고매소장구균。결론아원노년과환자감염이호흡도감염위주，세균내약성일추엄중，탄청매희류항생소대장간균과세균잉유교고적항균활성。
Objective To investigate the distribution and antibiotic resistance of clinical isolates from geriatrics department of Sichuan Provincial People's Hospital during 2012 in order to guide the clinical treatment.Methods The source of the culture speci-mens,distribution of pathogens,and the drug resistance were taken for statistical analysis from January to December in 2012.Results A total of 2598 strains of pathogens were isolated including the gram-negative microorganisms and gram-positive microorganisms ac-counting for 78.91%and 21.09%,respectively.The first occupying five clinical isolates were Pseudomonas aeruginosa,Escherichia co-li,Pneumobacillus,Acinetobacter and Citrobacter.About 55.86% of Escherichia coli and 35.4% of Klebsiella pneumoniae were ES-BLs-producing strains.The resistance rate of Escherichia coli against carbapenems was less than 3.8%.The resistance rate of Pseudo-monas aeruginosa against imipenem was 66.96%,while against amikacin and piperacillin/tazobactam were relative? low(4.16% and 13.69%,respectively) .The resistance rate of Acinetobacter baumannii against imipenem was 58.74%.The detection rates of Methicil-lin-resistant Staphylococcus aureus(MRSA)and Coagulase-negative Staphylococcus(MRCNS)were 65.82% and 79.23%,respective-ly.The prevalence of E.faecalis strains and E.faecium in enterococcus was 16.67%and 83.33%,respectively.There were two strains of MRCNS and two strains of E.faecium resistant to vancomycin.Conclusion The geriatric infection was dominated by respiratory sys-tem infection in our hospital.The antibiotic resistance is increasing seriously.The antibacterial activity of Escherichia coli against car-bapenems is still high.We should strengthen the surveillance of bacterial resistance,and use antibiotics reasonably.
