665株多药耐药菌的监测与分析

Monitoring and analysis of 665 strains of multidrug-resistant bacteria

目的了解医院感染多药耐药菌分布及耐药状况,促进合理用药及医院感染的预防控制。方法对医院2009年1月-2010年12月发生的医院感染送检标本所分离的多药耐药菌株进行回顾性分析。结果 665株多药耐药菌株,其中产超广谱β-内酰胺酶(ESBLs)的细菌居第一位,占31.7%,耐甲氧西林凝固酶阴性葡萄球菌占29.6%,多药耐药鲍氏不动杆菌占14.6%;ICU共分离出126株多药耐药菌,其中多药耐药鲍氏不动杆菌居第一位,占38.9%。结论医院感染多药耐药菌株以产ESBLs的细菌为主,ICU感染以多药耐药鲍氏不动杆菌为主,医院感染预防控制压力大,应加强多药耐药菌医院感染控制工作,实施目标性监测,预防和控制多药耐药菌的传播,并加强抗菌药物的合理应用。

OBJECTIVE To analyze the distribution of multidrug-resistant bacteria（MDRB） in nosocomial infection,so as to improve the rational use of antibiotics and nosocomial infections prevention.METHODS A retrospective analysis was performed for the MDRB isolated from the specimens of nosocomial infection patients in our hospital from Jan.2009 to Dec.2010.RESULTS A total of 665 strains of MDRB were collected.There were 211（31.7%） strains of bacteria producing extended spectrum β-lactamase（ESBLs）,197（29.6%）strains of methicillin-resistant coagulase negative Staphylococcus,and 97（14.6%） strains of multidrug-resistant Acinetobacter baumannii.A total of 126 strains of multidrug-resistant bacteria were isolated in ICU,of which multidrug-resistant A.baumannii was dominant（49 strains,38.9%）.CONCLUSION Bacteria producing extended spectrum β-lactamase（ESBLs） are the main multidrug-resistant strains in nosocomial infection and multidrug-resistant Acinetobacter baumannii is most common in ICU.This is a big challenge for prevention and control of nosocomial infection.Prevention of MDRB infection and control of the spreading should be reinforced.Targeted monitoring should be implemented and rational use of antibiotics should also be emphasized.