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目的 :了解天津地区临床分离的医院内、外感染病原菌的耐药情况。方法 :对天津市8所大型综合医院2001年3月—2002年3月临床分离的3273株细菌进行药敏测定 ,同时判断菌株来源是否为医院内感染。结果 :3273株细菌中革兰氏阳性菌占24 9 % ,革兰氏阴性菌占75 1 % ,耐甲氧西林金黄色葡萄球菌 (MRSA)和耐甲氧西林凝固酶阴性葡萄球菌 (MRCNS)分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的51 7%和65 6 %。肠球菌耐万古霉素株约占肠球菌的1%。大肠杆菌和肺炎克雷白杆菌产超广谱 β-内酰胺酶 (ESBL)发生率分别为29 7 %和32 8%。绿脓杆菌对头孢他啶和亚胺培南的耐药率为26 8 %和18 2%。窄食嗜麦芽单胞菌对左旋氧氟沙星和复方磺胺甲恶唑的耐药率分别为15 9 %和7 7 %。绝大多数病原菌医院内感染株的耐药率高于社区感染株 ,两者之间差别有统计学意义。结论 :应针对医院内、外感染合理使用抗生素 ,对控制医院内感染的发生及耐药播散意义重大
OBJECTIVE: To understand the drug resistance of pathogenic bacteria in hospital and outside the hospital in Tianjin. Methods: 3273 strains of bacteria isolated from 8 large-scale general hospitals in Tianjin from March 2001 to March 2002 were tested for susceptibility and the origin of the strains was confirmed as nosocomial infection. Results: Gram-positive bacteria accounted for 24 9%, gram-negative bacteria 75 1%, methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococcus (MRCNS) Accounting for 51 7% and 65 6% of Staphylococcus aureus and coagulase negative staphylococci, respectively. Enterococci vancomycin-resistant strains account for about 1% of enterococci. Escherichia coli and Klebsiella pneumoniae production of extended spectrum β-lactamase (ESBL) incidence was 29 7% and 32 8%. The resistance rates of Pseudomonas aeruginosa to ceftazidime and imipenem were 26.8% and 182%, respectively. Resistant rates of levofloxacin to levofloxacin and sulfamethoxazole were 15 9% and 77%, respectively. The resistance rates of the most infected isolates in hospital were higher than those in community isolates, the difference was statistically significant. Conclusion: Reasonable use of antibiotics in hospital for infection and external infection should be of great significance to control the occurrence of hospital infection and spread of drug resistance