病房环境含菌量与耐药菌株监测及分析

Monitoring and analysis of ward environmental bacteria content and drug resistant strain

[目的]了解病房环境含菌量和耐药菌株的情况,为医院感染治疗用药提供依据。[方法]每周一次定点、定期、定人对病房空气、床头柜、医护人员手进行消毒前后取材进行菌落数、致病菌及药敏监测。[结果]病房空气、床头柜、医护人员手消毒前后结果比较有统计学意义(P<0.01)。共送检5720份标本,检出菌株862株,检出率为11.05%,以革兰阳性球菌居多(335株),其次为革兰阴性杆菌(278株);其中大肠埃希菌对复方新诺明耐药率,2000年为42.2%,2004年为93.5%。葡萄球菌对头孢唑啉耐药率,2000年为59.1%,2004年为90.1%。[结论]通过消毒有效杀灭大部分存活细菌,坚持定期消毒是十分必要的,但耐药菌仍有上升趋势。建议使用敏感的抗生素并循环使用。

Objective; To know the status quo of both wards environment bacteria contcnt and the drug resistance strain, to providc a basis for the medication of patients with nosocomial infection. Method; Samples collected from ward air, bedside cupboards and hands of medical staffs both before and after disinfection on the fixed time point and same individuals every week were analyzed on colony counts, pathogenic bacteria and drug sensitivity monitoring. Result： There were significant statistical differences in terms of the bacteria content of ward air, bedside cupboards, and hands of medical and nursing staffs between before and after the disinfection （P〈 0.01）. Among the total of 5 720 pieces of samples, 862 strains were detected. And the detected rate accounted for 11.05 %. Most of the detected strains were gram positive coccus （335 strains）, gram negative bacilli were in the second place （278 strains）. Drug resistant rates of Escherichia coli to trimethoprim-sulfamethoxazole were 42.2 % in 2000 and up to 93, 5 % in 2004 respectively. Drug resistant rates of staphylococci to Cefazolin were 59.1% in 2000 and up to 90.1% in 2004. Conclusion： It is essential to keep on sterilization timely to kill living bacteria. Resistant bacteria are still in rising tendency. It is proposed that one should give sensitive antibiotics for patients with infection and medicate in cycle.