目的:分析2009 ～ 2011 年本院3a 临床分离病原菌的耐药状况，指导临床合理使用抗菌药物，积极
控制医院感染。方法:用稀释法进行抗菌药物敏感实验，根据CLSI 2012 年标准用WHONET 5． 6 软件进行数据
分析。结果: 3a 临床分离出常见病原菌4344 株，其中革兰阳性球菌1685 株占38． 8%。革兰阴性杆菌2659 株，
占61． 2%;各年耐甲氧西林金黄色葡萄球菌( MRSA) 检出率分别为65． 4% ( 71 株) 、64． 9% ( 92 株) 、59． 9% ( 103
株) 。金黄色葡萄球菌对青霉素和红霉素的耐药率最高都在86%以上，未发现耐万古霉素和利奈唑胺的黄色葡
萄球菌。屎肠球菌的耐药率高于粪肠球菌的耐药率。大肠埃希菌和肺炎克雷伯菌对哌拉西林/他唑巴坦、头孢
替坦和亚胺培南的耐药率较低均小于2%，鲍曼不动杆菌对各类抗菌药物耐药率普遍较高，对头孢曲松耐药率
高达99． 5%，铜绿假单胞菌对头孢曲松耐药率也高达99． 0%。结论: 细菌耐药性仍呈上升趋势，应完善抗菌药
物的规范使用，加强细菌培养意识。需要关注耐甲氧西林金黄色葡萄球菌、耐万古霉素肠球菌、耐碳青霉烯类肠
杆菌科细菌及多药耐药鲍曼不动杆菌和铜绿假单胞菌，采取积极措施控制病原菌的耐药趋势进一步恶化。
关键词:病原菌;抗菌药物;细菌耐药性监测

Objective: To investigate the drug resistance status of the clinical isolated pathogenic
bacteria in our hospital from 2009 to 2011，guide clinical rational use of antimicrobial drugs，and to actively
control hospital infection． Methods: Drug sensitivitity were detected by dilution method． The data
were analyzed by WHONET 5． 6 software according to the standard of CLSI 2012． Results: Total of
4344 strains were isolated and identified including 1685 strains of Gram－positive coccus( 38． 8%) ，
2659 strains of Gram － negative bacilli ( 61． 2%) ． The detection rate of MRSA was 65． 4% ( 71
strains) ， 64． 9%( 92 strains) ， 59． 9%( 103 strains) from 2009 to 2011， respectively． Staphylococcus aureus
had higher resistance rate to penicillin and erythromycin( ≥86%) ． There were no vancomycin－resistant
and linezolid－resistant Staphylococcus aureus detected． The drug resistance rate of E． faecium is
higher than that of E． faecalis． E． coli and K． pneumoniae had lower resistance rate to piperacillin /
tazobactam，cefotetan and imipenem( ≤2%) ． Acinetobacter baumannii had generally higher resistance
rate to many kinds of antibacterial drugs，especially higher to ceftriaxone( 99． 5%) ． The resistance rate
of Pseudomonas aeruginosa to ceftriaxone also is as high as 99． 0%． Conclusions: The drug resistance
of bacteria continued to show an upward trend． we should attach importance to the status of drug resistance
and take effective measures and administrate antibacterial drugs scientifically and rationally．

R978． 1