佛山市院内感染的监测及其致病菌的耐药性研究

Hospital Acquired Infection Surveillance and Drug Resistance of Pathogenic Bacteria in Foshan

目的了解及分析本院以及本市临床细菌及真菌院内感染的特点及耐药状况,为临床提供合理使用抗生素的建议及指引,以达到减少院内感染和控制耐药率上升的目的。方法采用VITEK-AMS全自动微生物分析仪与手工K-B法相结合的方法,对本院2006年1～12月临床各类送检标本进行分离培养并检测其对多种抗生素的耐药性;采用WHONET5软件,从送检科室、标本类别、分离菌种及其对抗生素的耐药性等方面进行统计和分析,得出一系列有建设性的研究数据。结果共检测标本13391例,阳性3758例,阳性检出率28.1%,院内感染以大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌最常见;真菌亦有6.01%的检出率;院内感染主要以呼吸道、泌尿道及外科感染为主;所有检出的菌株对临床各种常用抗生素均呈不同程度的耐药性,且其多重耐药呈增加趋势。结论开展院内感染及其致病菌耐药性监测,对于合理用药、提高疗效、减缓细菌耐药率以及控制院内感染均有重要意义。

Objective To analyze the hospital acquired infection（HAI） and drug resistance of pathogenic bacteria in our hospital and the hospitals of Foshan city in an attempt to provide reasonable use of antibiotics for clinical recommendations and guidelines to achieve the reduction of HAl and control of increasing drug resistance rate. Methods All the bacteria samples were collected from our hospital and the hospitals of Foshan city during Jan. 2006 to Dec. 2006. The samples were isolated,cultured and detected by VITEK-AMS automierobiology system and manual K-B methods. And then the WHONET-5 software was used for statistics analysis of those data including submission sections,specimen type, separating bacteria and their resistance to antibioticsin order to draw a series of constructive data. Results From all 13391samples,3758 samples were positive,with the positive rate of 28.1% ,and /he first five pathogenic bacteria of HAI were E.cole,P.aeruginose,S.aureus,K.pneumoniae and fungus（6.01%）. HAI showed mainly in the respiratory tract,mainly urinary tract and surgical infections. All the strains detected showed varying degrees of drug resistance to commonly used drugs. Conclusion The surveillance of both HAI and pathogens is of great importance in rational drug use,improvement of curative efficacy, decrease in the rate of bacterial resistance and control of HAI.