医院感染病原菌分布特征及耐药性分析

Distribution of pathogens causing nosocomial infections and analysis of drug resistance

目的了解医院感染病原菌的来源分布及耐药性。方法对2009-2010年医院感染病原菌的来源及药敏结果进行统计分析。结果进行病原学送检的790例医院感染患者中分离出病原菌509株,以革兰阴性杆菌为主占63.5%,主要是肠杆菌科的大肠埃希菌、肺炎克雷伯菌及非发酵菌属的铜绿假单胞菌、鲍氏不动杆菌;产ESBLs大肠埃希菌检出率为82.3%,产ESBLs肺炎克雷伯菌检出率为73.9%,鲍氏不动杆菌耐药性较突出,亚胺培南耐药率为34.9%;革兰阳性球菌占21.8%,以表皮葡萄球菌和金黄色葡萄球菌为主,MRSE检出率为87.5%,MRSA检出率为29.4%,未检出耐万古霉素肠球菌。结论为控制细菌的耐药性,须加强抗菌药物的合理使用;为减少耐药菌的传播,须加强耐药菌的监测和消毒隔离,规范洗手。

OBJECTIVE To understand the distribution and drug resistance of pathogens causing nosocomial infections.METHODS Statistical analysis of sources and the drug susceptibility of the pathogens causing nosocomial infections was carried out from 2009 to 2010.RESULTS Among 509 strains of pathogens isolated from 790 submitted patients,63.5% were gram-negative bacilli including Escherichia coli and Klebsiella pneumoniae of Enterobacteriaceae,and Pseudomonas aeruginosa and Acinetobacter baumannii of non-fermenting bacteria.The detection rate of ESBLs-producing E.coli was 82.3%,the detection rate of ESBLs-producing K.pneumoniae was 73.9%;the drug resistance of A.baumannii was relatively serious,the drug resistance rate to imipenem was 34.9%;gram-positive cocci occupied 21.8%,mainly including Staphylococcus epidermidis and S.aureus,and the detection rate of MRSE was 87.5%,MRSA 29.4%,and no vancomycin-resistant Enterococcus were detected.CONCLUSION In order to control the drug resistance of bacteria and reduce dissemination of drug resistant bacteria,the rational use of antibiotics,the surveillance of drug resistant bacteria,disinfection and isolation,and standard washing hands should be strengthened.