近三年我院医院感染菌种及抗生素敏感性分析

The analysis of infection strains and antibiotic sensitivity of our hospital in recent three years

目的分析我院近三年医院感染的病原菌和抗生素的敏感性。方法对医院感染的2224例病人进行相应部位分泌物的细菌培养,应用法国生物梅里埃ATBExpression鉴定药敏系统,结果按NCCLC2004年版标准判断。结果三年中,医院感染病原菌以革兰阴性杆菌为主,占60.99%,常见的是铜绿假单孢、大肠埃希氏、肺炎克雷伯,革兰阳性细菌有逐年增多趋势,以葡萄球菌为主。革兰阴性杆菌对氨苄西林、哌拉西林及二代头孢菌素已普遍产生较高的耐药率,对三代头孢菌素的耐药率已达60%以上。葡萄球菌对青霉素、氨苄西林、苯唑西林、红霉素的耐药率较高,未发现耐万古霉素。产ESBLs的大肠埃希菌和肺炎克雷伯,对大多β内酰胺类抗菌药物高度耐药,对亚胺培南及部分加酶第三代头孢还有较高敏感性。常见的感染部位是下呼吸道、上呼吸道和泌尿道。感染率较高的科室是ICU、神经内科、肾内科、血液内科。结论医院感染病原菌主要为条件致病菌,以革兰氏阴性杆菌为主,革兰氏阳性细菌有增多趋势,耐药率明显上升。对我院及本地区医院感染中抗生素的选用具有一定的参考价值,亦可为临床医生提供经验用药的依据。

Objective To analysis the infection strains and antibiotic sensitivity of our hospital in recent three years. Methods The secretion substances of 2224 hospital infected patients were employed with bacterial culture. The method of identification of antibiotic sensitivity is France biology Merieus ATB Expression, to judge the result with NCCLC2004. Results The primary pathogenic bacteria of hospital infection is Gram-negative rod in the three years, at.counting to 60.909%, most of them are P. aeruginosa, E. c.oil and Khbsiella spp, but the Gram-positive bacteria is becoming more common, most of them are staphylecoeci. Gram-negative rod has high drug resistance rate to ampiciUin, piperaeillin and the second generation cephalosporin, and about more than 60% of them has drug resistance to the third generation cephalosporin. Staphylococci has higher drug resistance rate to penicillin, ampicillin, oxacillin and erythromycin, but it has no dzug resistance to vancomycin. The E.coil and Khbsiella spp producing ESBLs have higher drug resistance rate to β laetamases antibiotics than to imipenem and part of the third generation cephalosperin added with enzyme, The common infected position are lower respiratory tract, upper respiratory and tract urinary tract. The department of intensive care unit, nephrology and hemotology have higher infection rate. Conclusions The most hospital infection strains are conditional pathogenic bacteria, the primary bacterium is Cram-negative rod, but the Gram-positive bacteria is becoming more common, the drug resistance rate become significantly higher. It can be a reference for clinician to chose antibiotic in our region and providing evidence for empirical medication.