目的 了解成都医学院第一附属医院病原菌的分布与耐药性,为临床合理使用抗菌药物提供依据。方法 回顾性分析成都医学院第一附属医院2013年病原菌的鉴定及药敏结果。结果 共分离出病原菌3 805株,其中革兰阴性菌2 484株(65.3%),主要包括大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌肺炎亚种;革兰阳性菌928株(24.4%),以金黄色葡萄球菌为主;真菌393株(10.3%),主要为白假丝酵母菌。药物敏感试验显示,革兰阴性菌中大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌肺炎亚种仍均对碳青霉烯类及青霉素、头孢菌素类/β-内酰胺酶抑制剂保持着较高的敏感率,而鲍曼不动杆菌的耐药现象较严重,仅对多黏菌素E高度敏感;革兰阳性菌均对万古霉素保持着高度敏感率,而对红霉素等大环内酯类及青霉素的耐药现象较严重;真菌中白假丝酵母对5-氟胞嘧啶、氟康唑、伏力康唑、两性霉素B、伊曲康唑的敏感率均较高。结论 应定期统计分析本院病原菌的分布及药敏情况,使临床医生依此合理使用抗菌药物,从而提高感染治愈率和延缓耐药菌的产生。

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.