潘海燕　向永红　吕聪

[摘要] 目的 分析广西壮族自治区民族医院（以下简称“我院”）2013～2015年临床分离病原菌的分布及耐药情况，为临床合理使用抗菌药物提供参考依据。 方法 收集2013年1月～2015年12月我院临床科室送检的标本进行检测，采用VITED-Ⅱ Compact 60全自动细菌鉴定仪对病原菌进行鉴定及药敏试验。 结果 共分离出病原菌10 453株，革兰阴性菌8948株（85.60%），革兰阳性菌1505株（14.40%），前5位依次为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、凝固酶阴性葡萄球菌。肠杆菌科细菌及铜绿假单胞菌对亚胺培南、阿米卡星、头孢哌酮/舒巴坦及哌拉西林/他唑巴坦的敏感性较高，而鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率达39.68%，对余常见抗菌药物耐药率较高。 结论 我院病原菌以革兰阴性菌为主，对常用抗菌药物的耐药率偏高，应根据病原菌的分布及耐药性合理选用抗菌药物。

[关键词] 病原菌；抗菌药物；耐药性；合理用药

[中图分类号] R563.1 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0160-04

Distribution and drug resistance of clinical pathogenic bacteria in our hospital from 2013 to 2015

PAN Haiyan XIANG Yonghong LYU Cong

Guangxi Zhuang Autonomous Region National Hospital Nationnal Hospital Affiliated to Guangxi Medical University， Guangxi Zhuang Autonomous Region， Nanning 530001， China

[Abstract] Objective To analyze the distribution and drug resistance of clinical pathogenic bacteria in Guangxi Zhuang Autonomous Region National Hospital （“our hospital” for short） from 2013 to 2015， and to provide guidance for reasonable clinical drug use. Methods Clinical specimens were collected from hospitalized patients in our hospital from January 2013 to December 2015. Bacterial identification and drug susceptibility testing were performed by VITED-Ⅱ Compact 60. Results A total of 10 453 strains of pathogens were isolated from the three years， among which the gram-negative bacteria were 8948 strains （85.60%）， and gram-positive bacterium were 1505 strains （14.40%）. The top 5 species were Escherichia coli， Klebsiella pneumonia， Pseudomonas aeruginosa， Acinetobacter baumannii and Coagulase negative staphylococcus aureus. Enterobacteriaceae bacteria and Pseudomonas aeruginosa had high drug sensitive rates to Imipenem， Amikacin， Cefoperazone/Sulbactam and Piperacillin/Tazobactam. Drug resistance of Acinetobacter baumannii to Cefoperazone/Sulbactam was 39.68%， which had higher drug resistance to commonly used antibiotics. Conclusion The main hospital pathogenic bacteria are gram-negative bacteria， and they have high drug resistance rate to common antibacterial， thus reasonable use of antibiotics should be based on the distribution and drug resistance of pathogenic bacteria.

[Key words] Pathogens； Antibiotics； Drug resistance； Rational drug use

近年來，随着抗菌药物在临床实践中的广泛应用，细菌变异速度加快，多重耐药细菌问题日益突出，多重耐药菌已经成为医院感染重要的病原菌。我国2016年CHINET细菌耐药监测网的耐药信息监测资料显示，革兰阴性菌的细菌耐药性问题日趋严重[1]，临床上对于某些耐药菌感染的治疗方法极为有限[2]。不同地区、不同医院、不同时间、甚至不同性别均有差异[3]，因此，了解医院常见病原菌分布及其耐药性，对指导临床合理使用抗菌药物十分重要。……