西藏拉萨地区常见致病菌及其耐药性分析

目的研究2009年至2011年西藏拉萨地区主要医院的常见致病菌及其耐药性情况。方法采集拉萨市临床医院细菌感染性疾病临床标本1 200份进行致病菌的分离。采用法国梅里埃-ATB菌种鉴定仪对分离的菌株鉴定到种,参照2010年CLSI推荐方法进行耐药性分析。结果对拉萨地区主要临床医院的感染者标本分离鉴定出332株临床致病菌,其中细菌304株(91.57%),真菌28株(8.43%)。病原细菌分布主要为革兰阳性球菌97株,占29.22%;革兰阴性杆菌200株,占60.24%;其他菌7株,占2.11%。凝固酶阴性葡萄球菌对苯唑西林﹑头孢曲松和环丙沙星的耐药率分别为72%﹑40%和44%。大肠埃希菌对氨苄西林﹑哌拉西林和头孢唑林耐药率分别为83%﹑53%和43%。克雷伯菌属对氨苄西林﹑头孢唑林耐药率分别为86%和58%。铜绿假单胞菌和不动杆菌对亚胺培南的耐药率分别高达20%和19%。结论拉萨地区的细菌感染及其耐药菌株分布较为广泛,该地区应加强常规临床致病菌的耐药性监测以指导临床医师合理使用抗菌药物。

Analysis of clinical pathogenic bacteria and drug resistance in Lasha

Objective To investigate the common clinical pathogenic bacteria and antimicrobial drug resistance from 2009 to 2011 in Lasha hospitals.Methods A total of 2 000 clinical samples were cultured,by using ATB instrument(France) for identification and antimicrobial drug sensitivity analysis based on CLSI recommendation method.Results 332 strains were isolated from 2 000 samples.The isolates included Gram-negative bacilli(60.24%),Gram-positive coccus(29.22%) and Fungi(8.43%).Escherichia coli and coagulase negative cocccus are the main pathogens.The resistance rate of coagulase negative cocccus to oxacillin,ceftriaxone and ciprofloxacin is 72%,40% and 44% respectively.The resistance rate of E.coli to ampicillin,piperacillin and cefazolin is 83%,53% and 43% respectively.The resistance rate of Klebsiellae to ampicillin and cefazolin is 86% and 58% respectively.The resistance rate of Pseudomonnas aeruginosa and Acinetobacter is 20% and 19%.Conclusion It's necessary to strengthern the monitoring of nosocomial infection and antimicrobial drug resistance,and provide the regular education in clinical application of rational use of antimicrobial drugs in lasha hospitals.