陈果+李蔚+李小惠

[摘要]目的 探讨四川省人民医院2014年临床分离病原菌的分布及耐药性，为临床用药提供参考。方法 对2014年本院送检临床标本中分离出的病原菌分布及其耐药情况进行统计分析。结果 9817株病原菌中，革兰氏阴性菌6607株，占总分离率的67.3%，肺炎克雷伯菌及大肠埃希菌产超广谱β内酰胺酶分别为34.1%、59.2%；革兰氏阳性菌3210株，占总分离率的32.7%，耐甲氧西林金黄色葡萄球菌（MRSA）为25.8%，耐万古霉素屎肠球菌为9.9%。分离前四位的病原菌分别为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌。病原菌对抗菌药物的耐药率较高，革兰氏阴性菌对碳青霉烯、酶抑制剂复合剂和阿米卡星的敏感性较高。革兰氏阳性菌对替加环素、万古霉素、利奈唑胺的敏感性较高。结论 2014年本院分离的病原菌耐药现象较为普遍，开展细菌耐药性监测，指导临床合理使用抗生素，对降低医院感染率和控制细菌耐药性有重要意义。

[关键词]病原菌；耐药性；抗菌药

[中图分类号] R978.1 [文献标识码] A [文章编号] 1674-4721（2016）06（c）-0035-04

[Abstract]Objective To explore the distribution and drug resistance of clinical isolated pathogenic bacteria of Sichuan Provincial People′s Hospital during 2014，and to provide reference for clinical medication.Methods Distribution and drug resistance of pathogens isolated from patients in the hospital in 2014 were analyzed statistically.Results In the 9817 pathogen strains isolated，6607 strains were Gram-negative bacilli，and 3210 strains were Gram-positive cocci，the percentage of the two groups were 67.3% and 32.7%.ESBLs producing rates of Escherichiacoli and Klebsiella pneumoniae were 59.2% and 34.1%.Meticillin-resistant strains of Staphylococcus aureus （MRSA） and Vancomycin-resistant enterococcus faecium （VREF） accounted for 25.8% and 9.9% respectively.The top four populations of pathogens isolated were Escherichia coli，Flebsiellapneumonia，Pseudomonas aeruginosa，and Acinetobacter baumannii.Pathogenic bacteria were higher resistant to the commonly used antibiotics.The Gram-negative bacteria were sensitive to carbapenem antibiotics，antibiotics combined with β-lactamases inhibitor，and amikacin.The Gram-positive bacteria were sensitive to tigecycline，vancomycin and linezolid.Conclusion Drug resistance of bacterial isolated from our hospital is a common phenomenon.It is necessary to carry out the surveillance of bacterial resistance for rational use of drug，reduction of rate of hospital infection and well control of bacterial drug resistance.

[Key words]Pathogens；Drug resistance；Antimicrobial agents

随着广谱抗生素的广泛使用，病原菌耐药问题日趋严重，尤其是多重耐药、泛耐药甚至全耐药菌株的出现和增多，给医患和社会造成很大困扰[1-2]。由于细菌分布的区域性不同等各种因素，我国不同地区医院的耐药情况各不相同。准确掌握医院细菌感染的特点和动态变化，加强耐药菌监测，具有重要意义。现将四川省人民医院2014年度临床分离病原菌分布及耐药监测情况报道如下。……