基层医院多重医院感染的病原菌分布及耐药分析

Pathogen Distribution and Resistance Analysis of Multi-Hospital Infection in Grass-roots Level Hospital

目的了解基层医院多重医院感染病原菌的临床分布及对常用抗菌药物的耐药情况,以指导临床的合理用药。方法对2005年1月～2008年10月住院患者中多重医院感染病例分离到的病原菌,进行菌种分布和耐药性的回顾统计分析。结果临床所分离的284株病原菌中,革兰阴性菌132株,占46.48%,革兰阳性菌84株,占29.58%,真菌48株,占16.90%;前5位病原菌依次为葡萄球菌属、假单胞菌属、真菌、鲍氏不动杆菌和肺炎克雷伯菌;病原菌耐药显示革兰阳性菌除万古霉素、替考西林、夫西地酸、呋喃妥因较敏感外,其余大多耐药率>60.00%;革兰阴性菌对美罗培南、亚胺培南、阿米卡星、哌拉西林他唑巴坦的耐药率较低外,对其他常用抗菌药物的耐药率大多>50.00%。结论基层医院多重医院感染的病原菌仍以革兰阴性菌为主,病原菌耐药严重;重视病原菌检查及药敏监测,对控制多重医院感染及临床合理应用抗菌药物有指导意义。

OBJECTIVE Learning clinical distribution of pathogens of multiple-hospital infection in grass-roots hospital ,to guide rational using clinical drug. METHODS The statistical analysis of distribution and resistance of pathogens isolated from multi-hospital infections from Jan 2005 to Oct 2008 were recalled. RESULTS In 284 pathogens isolated from clinic,there were 132 G^-bacteria （accounted for 46.48%）,84 G^＋ bacteria （ accounted for 29.58%） and 48 fungi （accounted for 16.90%）. Drug-resistant pathogens showed that most G＋ bacteria＇s resistance rate was 60%,except for vancomycin,teicoplanin,fusidic acid and nitrofurantoin. G^-bacteria＇s resistance rate to other commonly used antimicrobial agents was 50%,except for meropenem,imipenem,amikacin ,and piperacillin/tazobactam. CONCLUSIONS The most pathogens of multi-hospital infection in grass-roots hospital are G-bacteria. Attaching importance to pathogen and drug sensitivity inspection can guide controlling multi-hospital infection and rational using clinical antibiotics.