目的 了解成都醫(yī)學(xué)院第一附屬醫(yī)院病原菌的分布與耐藥性,為臨床合理使用抗菌藥物提供依據(jù)。方法 回顧性分析成都醫(yī)學(xué)院第一附屬醫(yī)院2013年病原菌的鑒定及藥敏結(jié)果。結(jié)果 共分離出病原菌3 805株,其中革蘭陰性菌2 484株(65.3%),主要包括大腸埃希菌、鮑曼不動(dòng)桿菌、銅綠假單胞菌、肺炎克雷伯菌肺炎亞種;革蘭陽(yáng)性菌928株(24.4%),以金黃色葡萄球菌為主;真菌393株(10.3%),主要為白假絲酵母菌。藥物敏感試驗(yàn)顯示,革蘭陰性菌中大腸埃希菌、銅綠假單胞菌、肺炎克雷伯菌肺炎亞種仍均對(duì)碳青霉烯類及青霉素、頭孢菌素類/β-內(nèi)酰胺酶抑制劑保持著較高的敏感率,而鮑曼不動(dòng)桿菌的耐藥現(xiàn)象較嚴(yán)重,僅對(duì)多黏菌素E高度敏感;革蘭陽(yáng)性菌均對(duì)萬(wàn)古霉素保持著高度敏感率,而對(duì)紅霉素等大環(huán)內(nèi)酯類及青霉素的耐藥現(xiàn)象較嚴(yán)重;真菌中白假絲酵母對(duì)5-氟胞嘧啶、氟康唑、伏力康唑、兩性霉素B、伊曲康唑的敏感率均較高。結(jié)論 應(yīng)定期統(tǒng)計(jì)分析本院病原菌的分布及藥敏情況,使臨床醫(yī)生依此合理使用抗菌藥物,從而提高感染治愈率和延緩耐藥菌的產(chǎn)生。

Objective To investigate distribution and drug resistance of pathogens in the First Affiliated Hospital of Chengdu Medical College in 2013, and to provide the basis for the clinical rational use of antibiotics. Methods The clinical data of pathogens in the First Affiliated Hospital of Chengdu Medical College in 2013 were reviewed retrospectively. Results Totally 3 805 strains of pathogens were isolated, including 2 484 strains (65.3%) of Gram-negative bacilli among which Escherichia coli, Enterobacter cloacae, Pseudomonas aeruginosa, and Klebsiella pneumoniae pneumoniae were dominant; 928 strains (24.4%) of Gram-positive bacilli among which Staphylococcus aureus were dominant; 393 strains (10.3%) of fungi among which Candida albicans was dominant. Drug sensitivity test showed that Gram-negative bacilli including E. coli, P. aeruginosa, and K. pneumoniae pneumoniae were sensitive to carbapenems, penicillin, and cephalosporins/β-lactamaseinhibitors. While E. cloacae had higher resistance, only was sensitive to polymyxin E. Gram-positive bacilli were sensitive to vancomycin, while were resistant to macrolides such as erythromycin, and penicillin. C. albicans was sensitive to 5-fluorocytosine, fluconazole, voriconazole, amphotericin B, and itraconazole. Conclusion It is necessary to statistically analyze the distribution and drug resistance of pathogens periodically, so as to provide the basis for clinicians reasonably using antibiotics. Thus, it can improve the cure rate of infection and delay the generation of antibiotic resistant bacteria.