2009-2010年医院感染危险因素及病原学的回顾性分析

Risk Factors for Nosocomial Infection and Etiology during 2009-2010:A Retrospective Analysis

目的了解南京地区一所三甲医院的医院感染危险因素和病原菌抗菌谱情况。方法回顾性调查2009年7月-2010年6月医院感染患者的原发病、基础病、感染部位,以及各项危险因素;采用纸片扩散法(K-B法)对临床分离菌株进行药敏试验,以CLSI 2008年版为判断标准。结果患者原发疾病是肿瘤时,发生医院感染率最高,为13.0%;344株临床分离病原菌中,革兰阳性菌85株,占24.7%,革兰阴性杆菌180株,占52.3%,真菌79株,占23.0%;不动杆菌属和铜绿假单胞菌对碳青酶烯类抗菌药物耐药率较高,前者对亚胺培南和美罗培南的耐药率分别为69.2%和75.0%,后者对亚胺培南和美罗培南的耐药率分别为83.9%和50.0%。结论南京地区需重视耐碳青酶烯类抗菌药物的肠杆菌科病原菌的控制。

OBJECTIVE To explore the risk factors and the bacterial resistance profile of nosocomial infection in a Nanjing general hospital.METHODS All nosocomial infection cases were analyzed for risk factors from Jul 2009 to Jun 2010.And the antimicrobial susceptibility of 344 nosocomial infection isolates was tested according to CLSI 2008 edition by using Kirby-Bauer（K-B） method.RESULTS The high risk primary disease was cancer of 13.0%.Of the 344 nosocomial infection isolates,Gram-negative bacilli,Gram positive cocci and fungi accounted for 53.5%,24.7% and 23.0%,respectively.About 69.2%and 75.0% of Acinetobacter isolates were resistant to imipenem and meropenem respectively.About 83.9% and 50.0% of P.aeruginosa isolates were resistant to imipenem and meropenem respectively.CONCLUSION It should pay more attention to the control of imipenem and meropenem resistant bacilli.