静脉置管感染病原菌分布特点及耐药性分析

Pathogen Distribution and Drug Resistance in Venous Catheterization Infection

目的监测静脉置管病原菌的临床分布和耐药现状,为临床医生正确选用抗菌药物提供参考依据。方法细菌培养与鉴定按《全国临床检验操作规程》进行,药敏试验采用纸片扩散(K-B)法,耐甲氧西林葡萄球菌(MRS)的检测和超广谱β-内酰胺酶(ESBLs)的检测按美国临床实验室标准化委员会(NCCLS)标准进行。结果118株病原菌中,葡萄球菌属75株,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为35.0%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率为40.0%;革兰阴性杆菌41株,大肠埃希菌、肺炎克雷伯菌中ESBLs检出率为18.2%、30.0%;MRS对克林霉素、红霉素、环丙沙星等常用抗菌药物的耐药率均明显高于甲氧西林敏感葡萄球菌(MSS);亚胺培南对革兰阴性杆菌保持了很好的抗菌活性。结论应重视耐药菌的检测与报告,及时有效地控制医院感染的发生与流行。

OBJECTIVE To investigate antibiotic resistance and distribution of bacteria to provide reference for using antibiotics reasonably. METHODS Antibiotic susceptibility test was performed by K-B method, meticillin-resistant Staphylococcus （MRS） and ESBLs were identified according to NCCLS （2004） of the USA. RESULTS From in 118 strains of bacteria there were 75 Staphylococcus strains, and the isolated rate of meticillin-resistant S. aureus （MRSA） was 35.0%, and that of metieillin-resistant coagulase-negative S. aureus （MRCNS） was 40. 0%. Among 41 Gram-negative bacilli, ESBLs isolating rates in Escherichia coli and Klebsiella pneumoniae were 18. 2% and 30.0%, respectively. The resistant rate to clindamycin, erythromycin and ciprofloxacin in MRS was higher than in meticillin-sensitive Staphylococcus （MSS） significantly. Imipenem showed proper antibiotic activity to Gram-negative bacilli. CONCLUSIONS We should pay more attention to resistant strains to control the nosocomial infection outbreaking.