精神病院医院感染病原菌分布及耐药性分析

Distribution of pathogenic bacteria causing nosocomial infections and drug resistance in a psychiatric hospital

目的探讨2011年7-9月医院感染病原菌的分布及其耐药性,为临床合理应用抗菌药物提供依据。方法对临床送检的1684份标本进行分离,对病原菌构成及其耐药性进行分析。结果 1684份送检标本中共检出768份阳性,阳性率为45.6%,综合病区和老年病区的送检阳性率较高,分别为55.9%和48.4%;痰液送检阳性率为83.5%,检出病原菌中革兰阴性菌为55.9%,且产ESBLs及耐碳青霉烯类抗菌药物的菌株检出率较高,但部分仍对氨基糖苷类、碳青霉烯类、β-内酰胺酶抑制剂敏感;革兰阳性菌对常用抗菌药耐药率高,对万古霉素敏感。结论应加强对医院感染的预防控制,积极消除各种易感因素,重视标本的采集和菌株的分离及培养,合理使用抗菌药物。

OBJECTIVE To investigate the distribution and drug resistance of the pathogenic bacteria causing nosocomial infections from Jul to Sep 2011 so as to provide basis for reasonable clinical use of antibiotics.METHODS A total of 1684 clinically submitted specimens were cultured for the pathogenic bacteria,the distribution of the pathogens and the drug resistance were analyzed.RESULTS A total of 768 strains of pathogens were detected and the positive rate was 45.6%.The positive rates of samples from general departments and the geriatric departments were 55.9% and 48.4%,respectively,and the positive rate of sputum was 83.5%.The results suggested that the gram-negative bacteria accounted for 55.9%,the detection rates of ESBLs-producing strains and the carbopenem-resistant strains were high,and some of the strains remained sensitive to aminoglycosides and β-lactamase inhibitors.The gram-positive bacteria were highly resistant to the commonly used antibiotics,but sensitive to vancomycin.CONCLUSION The measures of prevention and control of the nosocomial infections need to be reinforced,and the predisposing factors should be get rid of.The clinical staff should pay attention to the sample collection and the isolation and culture of the strains and use antibiotics reasonably.