2009-2011年我院感染主要细菌的分布及耐药监测

目的了解近3年医院感染的主要细菌分布及其对抗菌药物敏感性情况。方法对本院2009年1月-2011年12月住院患者的15 868例标本进行细菌培养,分离出的细菌用美国德灵公司Microscan-walkaway 96全自动细菌鉴定仪进行鉴定和药敏分析。结果共分离出细菌142类,1 783株,其中G-菌1 443株（80.93%）,G＋菌340株（19.07%）。常见菌种分布依次为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍氏/溶血不动杆菌、金黄色葡萄球菌、表皮葡萄球菌、阴沟肠杆菌、屎肠球菌。1 783株细菌在各类标本中的分布以痰液最多,其次是尿液、血液、咽拭子、脑脊液、脓液等;常见菌种对多种抗菌药物的敏感性较低,各种肠杆菌属细菌对亚胺培南最为敏感,G＋菌对万古霉素最为敏感。结论近3年医院感染的细菌仍以G-菌为主,并主要存在于下呼吸道,且耐药严重。

Distribution of the major infection bacteria in our hospital from 2009 to 2011 and their drug resistance monitoring

Objective To investigate the distribution of the major hospital infection bacteria in our hospital from 2009 to 2011 and their drug resistance monitoring. Methods Bacteria in 15 868 samples from patients admitted to our hospital from January 2009 to December 2011 were cultured. The isolated bacteria were identified with Microscan-walkaway 96 and their drug sensitivity was analyzed. Results One hundred and forty-two kinds of bacteria including 1 783 strains were identified, of which 1 443 （80.93%） were Gram-negative strains and 340 （19.07%） were Gram-positive strains. The most common bacteria were Klebsiella pneumoniae （K. pneumoniae） followed by Escherichia coli （E. coli）, Pseudomonas aeruginosa （E aeruginosa）, Acinetobacter baumannii （A. baumanni）, Staphylococcus aureus （S. aureus）, Staphylococcus epidermidis （S. epidermidis）, Bacillus cloacae and Enterococcus faecalis （E. faecalis）. The 1 783 strains were mainly isolated from sputum followed by from urine, blood, throat swab, cerebrospinal fluid and pus. The common bacteria had a low sensitivity to several antibiotics. Different Enterobacteriaceae were most sensitive to imipenem and Gram-positive strains were most sensitive to vancomycin. Conclusion Gram-negative bacteria are the most common hospital infection pathogens in the recent 3 years, which are mainly distributed in the lower respiratory tract with a high drug resistance.