510株临床培养细菌的耐药性研究

目的了解不同地区、不同季节,本院分离的致病细菌发病的规律性及其对抗菌药物的耐药性。方法采用回顾性调查的方法,对2013年度全年所分离的病原菌所做的药敏实验结果按4个季度分类,以第4季度为样本与前3个季度进行比较分析。结果 2014年第4季度送检样本共3 200份,培养出细菌510株,阳性率为15.93%。其中革兰阴性菌326株（63.92%）,革兰阳性菌157株（30.78%）,其他27株（5.29%）。居前几位的菌株分别是大肠埃希菌（153/510,30.00%）、克雷伯菌属（80/510,15.68%）、铜绿假单胞菌（61/510,11.96%）、金黄色葡萄球菌（34/510,6.67%）和鲍曼不动杆菌（24/510,4.71%）。其中分离菌株居首位的大肠埃希菌对青霉素类药物和一代头孢的耐药性较高,分别为83.66%和71.24%;肺炎克雷伯菌依然对青霉素族的氨苄西林呈现较高的耐药性,对其他种类的抗菌药物耐药率均低于30%;葡萄球菌属中金黄色葡萄球菌对青霉素G的耐药率是94.1%。非发酵菌中的铜绿假单胞菌对主要抗菌药物依然呈现高耐药性。结论主要致病菌的耐药性与季节的更替无关联性,但却有逐年增长趋势。

Clinical research on drug resistance of 510 strains bacteria of clinical culture

Objective To investigate the drug resistance of pathogenic bacteria and the regularity of the onset of antibacterial drugs for different areas and different seasons. Methods The results of drug sensitivity test for pathogenic bacteria isolated in 2013 were analyzed retrospectively. The results of classificated according to the quarters, then the fourth quarter was taken as samples and compared with the first three quarters. Results The samples in the fourth quarter of 2014 were 3 200, from which there were 510 strains bacteria cultivation, with the positive rate of 15.93%. Among which, there were 326（63.92%） strains of Gram-negative bacteria, 157（30.78%） strains of Gram-positive bacteria, and 27（5.29%） strains other bacteria. The top of several types of bacteria were E. coli（30.00%, 153/510）, Klebsiella bacteria（15.68%, 80/510）, Pseudomonas aeruginosa（61/510, 11.96%）, Staphylococcus aureus（34/510, 6.67%） and Acinetobacter baumannii（4.71%, 24/510）, respectively. The drug resistance to penicillin and generation cephalosporins were higher of E. coli, with 83.66% and 71.24%, respectively. The drug resistance still high of Klebsiella pneumoniae to penicillin, and the drug resistance to the family of other kinds of antimicrobial all below 30%. The drug resistance of Staphylococcus aureus to penicillin G was 94.1%. The drug resistance was still high of Pseudomonas aeruginosa in fermentation bacteria to the main antibacterial drugs. Conclusion There was no association of the drug resistance of the main pathogenic bacteria and seasonal change, but actually has the trend of increased year by year.