医院获得性耐药菌感染分布特征及其规律性研究分析

Analysis of features and regularity of distribution of hospital acquired drug-resistant bacteria

目的探索我院耐药菌株的分布特征及规律，为临床早期制定治疗方案、合理应用抗生素提供依据。方法以765例患者共984株耐药菌为本次研究对象，对患者病历作回顾性调查，用SPSS10．0进行统计学分析，χ2检验用于比较各组间率的差异。结果耐药菌株的分布以革兰阴性杆菌为主，主要分布于下呼吸道、生殖泌尿道；耐药菌在夏季分布比例最大；耐药菌在高龄患者分布比例最大。医院常见革兰阴性耐药菌呈多重耐药性。结论医院耐药菌主要分布于夏、春两季，且多分布于高龄患者，以革兰阴性杆菌为主，以下呼吸道、生殖泌尿道最为多见。医院耐药菌感染尤其多重耐药革兰阴性菌感染以亚胺培南／西司他丁、头孢哌酮／舒巴坦治疗为较佳方案。

Objective To analyze the features and regularity of drug-resistant bacteria for basis in making therapeutic regimen and rational use of antibiotics in clinic. Methods A total of 984 strains of resistant bacteria isolated from 765 patients were tested. A retrospective study was performed on patients＇ case histories for the analysis on the distribution of resistant bacteria. Statistical analysis was made using SPSS 10. 0 and the differences among groups were compared using χ2 test. Results Of the total drug resistant strains, gram-negative resistant bacteria took the lead, and the bacteria were mostly seen in lower respiratory tract and genitourinary tract. Infection of drug resistant bacteria occurred more often in summer and showed the highest percentage in elder patients. The common gram-negative resistant bacteria in the hospital were found to be multidrug resistant in most cases. Conclusions Resistant bacteria were mostly seen in summer and spring, and showed the highest proportion in elder patients. Gram-negative bacteria were the main species and mostly seen in lower respiratory tract and genitourinary tract. Imipenem-cilastatin, cefoperazone psulbactam were the optimal therapy for drug-resistant bacterial infection,much as in cases of multidrug resistant gram-negative bacterial infection.