康复中心病区的医院感染特点及病原菌耐药性分析

Characteristics of Nosocomial Infection and Bacterial Strains in a Rehabilitation Center

目的了解康复中心的医院感染特点及康复中心病原菌检出情况及耐药现状,为临床合理使用抗菌药物提供参考。方法以主动监测与系统回顾相结合的方法,对2007年1月-2008年10月入住康复中心的912例患者的临床资料进行调查分析。结果康复中心的医院感染例次率16.9%,感染部位以呼吸道感染为主,其次是泌尿道感染;康复中心医院的病原菌以G-菌为主,检出前3位的病原菌是大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌,34株大肠埃希菌对氨苄西林的耐药率>83.0%,对喹喏酮类耐药率>70.0%;13株肺炎克雷伯菌对亚胺培南和美罗培南未发生耐药,10株铜绿假单孢菌对常用抗菌药物耐药呈不断上升趋势,对哌拉西林耐药率达90.0%。结论临床应合理应用抗菌药物,提高疗效、降低药物不良反应发生率,减少或减缓病原菌耐药性发生。

OBJECTIVE To investigate the characteristics of nosocomial infection, bacterial strains and antimicrobial resistance to provide references for the clinical application of drugs. METHODS Using the combined methods of reformations statistics, the analysis and the initiative monitoring and recalling system to carry on the clinical informations＇ statistics,the analysis and the judgment for the 912 inpatients in the rehabilitation center from Jan Oct, 2007 to oct, 2008 were undertaken.RESULTS The rate of nosocomial infection was 16.9%, the infection site was in mainly respiratory tract, the next was urinary tract. The pathogens were mainly Gram-negative bacteria, in whith Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the top three. The resistance rate of 34 strains of E. coli to ampicillin was up to 83. 0% and to quinolones was 70.0%. 13 strains of P. aeruginosa were sensitive to imipenem and meropenem. The resistance rate of K. pneumoniae to the common drug was raising, to piperacillin and aztreonam was 90.0%. CONCLUSIONS The antibiotics must be choosen rationally to enhance effectiveness, reduce side effect and make the resistant strains decreasing in number.