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目的了解该院2014年临床分离细菌构成及对常用抗菌药物的敏感性和耐药性,为临床用药提供参考依据。方法收集2014年全年临床送检标本分离的细菌,采用PHOENIX全自动细菌鉴定药敏系统、全自动血液培养仪或手工方法进行分离鉴定,对临床分离细菌采用自动化仪器法或K-B纸片扩散法进行药物敏感试验,采用WHONT 5.6软件进行统计分析,按CLSI 2012年标准判定结果。结果共分离细菌2 529株,革兰阳性菌537株(21.23%),革兰阴性菌1 992株(78.77%)。葡萄球菌属中甲氧西林耐药株(MRSA和MRCNS)对测试药物的耐药率均显著高于甲氧西林敏感株(MSSA和MSCNS),已发现对替考拉宁耐药菌株;肠球菌属中屎肠球菌的分离率、耐药性大多数超过粪肠球菌,二者均存在万古霉素和替考拉宁耐药菌株;肠杆菌科细菌产ESBLs株对测试药物的耐药率均比非产ESBLs株高,对碳青霉烯类药物敏感性高;非发酵菌中鲍曼不动杆菌耐药性突出,明显高于铜绿假单胞菌。结论该院临床细菌耐药呈增长趋势,应定期进行耐药性监测并采取有效的控制措施,抑制细菌耐药,为临床用药提供参考。
Objective To understand the composition of clinical isolates of bacteria and their sensitivity and resistance to commonly used antimicrobial agents in the hospital in 2014 and provide reference for clinical use. Methods The bacteria isolated from clinically tested specimens collected in 2014 were collected and identified by PHOENIX automatic bacterial identification system, automatic blood culture instrument or manual method. The clinical isolates of bacteria were analyzed by automated instrument or KB disk diffusion method Drug susceptibility testing, the use of WHONT 5.6 software for statistical analysis, according to CLSI 2012 criteria to determine the results. Results A total of 2 529 bacteria were isolated, 537 (21.23%) were Gram-positive bacteria and 1 992 (78.77%) were Gram-negative bacteria. The resistant rates of methicillin-resistant strains of Staphylococcus (MRSA and MRCNS) to the tested drugs were significantly higher than those of methicillin-sensitive strains (MSSA and MSCNS), and the resistant strains of teicoplanin, enterococci Enterococcus faecium in the isolation rate, the majority of drug resistance than Enterococcus faecalis, both vancomycin and teicoplanin resistant strains exist; Enterobacteriaceae ESBLs producing strains of drug resistance rates were tested It is more sensitive to carbapenems than non-ESBLs-producing strains, and Acinetobacter baumannii in non-fermentative bacteria is more resistant than Pseudomonas aeruginosa. Conclusion The clinical bacterial resistance in this hospital shows an increasing trend. Drug resistance monitoring should be carried out on a regular basis and effective control measures should be taken to inhibit bacterial resistance and provide reference for clinical use.