多重耐药菌以泌尿道感染为主临床分析

Clinical analysis of multiple bears the medicine fungus by urinary tract infection primarily

目的:了解二级医院多重耐药菌的病原菌特点及原因,对近2年94例住院患者的多重耐药菌感染情况进行回顾性调查分析。方法:对中段尿、痰液、血液等进行细菌培养,共分离120株多重耐药菌,并排除同一患者的重复菌株。其中G-杆菌76株,G+球菌44株;排在前5位的细菌依次为大肠埃希菌46株、肺炎克雷伯菌14株、屎肠球菌10株、母鸡肠球菌8株、产气肠杆菌6株;对常用抗菌药物有很高耐药性,药敏结果判断依据参照CLSI2008年标准。结果:本院住院患者多重耐药菌感染率为4.67%(94/2012),革兰阴性菌为63.33%(产超广谱β-内酰胺酶ESBLE的大肠埃希菌58.33%,肺炎克雷伯菌8.33%),革兰阳性球菌为36.67%。结论:近2年基层医院多重耐药菌感染率以尿路感染产ESBLE的大肠埃希菌为主,其次是肠球菌,耐万古霉素的肠球菌(MRSA)的感染率在本院无明显增多。要切实落实消毒隔离措施,尽量减少安置尿管,加强对泌尿道的护理,促进抗菌药物合理应用,以降低和控制多重耐药菌对患者的危害。

Objective：To understand that my courtyard multiple bears the medicine fungus the disease germ characteristic and the reason analysis,multiple bears the medicine fungus infection situation to the recent 2 years in-patient 94 examples to carry on the review diagnosis.Methods：The center-section urine,the sputamentum,the blood and so on were carried on the bacilliculture,altogether separates 120 multiple to bear the medicine fungus,eliminated the identical patient＇s redundant strain abreast in row.And G-bacillus 76,G＋ coccus 44;Arranges was in turn large intestine Egypt hopes fungus 46,pneumonia gram Reber fungus 14,excrement enterococcus 10,hen enterococcus 8 in the first 5 bacteria,produce was mad intestines bacillus 6;There was very high drug resistance to the commonly used antibiotics,the medicine sensitive result judgment rests on the CLSI 2008 year standard.Results：The courtyard in-patient multiple bears the medicine fungus infection percentage was 4.67%（94/2 012）,the Gram-negative bacteria was 63.33%（produce ultra broad spectrum Beta-lactan enzyme ESBLE the colon bacillus 58.33%,Klebsiella pnenmoniae 8.33%）,the Gelanshi masculine coccus was 36.67%.Conclusion：Recent 2 years basic unit hospital multiple bears the medicine fungus infection percentage to increase,and produces ESBLE by the urine road infection the large intestine Egypt to hope the fungus primarily,next is the enterococcus,bears the eternal mildew element the enterococcus（MRSA） the infection percentage increases not obviously in my courtyard;The conclusion must carry out the disinfection quarantine measures earnestly,strengthens to urinary tract nursing,the promotion antibiotics applies reasonably,reduces with the control multiple bears the medicine fungus to the patient the harm.