2011年医院感染病原菌分布及耐药性监测

Distribution and drug resistance of pathogens causing nosocomial infections in 2011

目的探讨医院2011年医院感染病原菌的菌种分布及耐药性,为临床合理用药提供参考依据。方法细菌的分离与鉴定严格按《全国临床检验操作规程》(第3版)进行操作;药敏试验采用K-B法进行,数据分析按CLSI2011年折点判读。结果医院2011年全年检出的454株病原菌中,以革兰阴性杆菌检出最高,占71.4%,其次是革兰阳性球菌,占21.6%,真菌占7.0%;病原菌对抗菌药物产生了不同程度的耐药性,变形菌属耐药率较低;铜绿假单胞菌对碳青霉烯类抗菌药物耐药率为7.7%;而肠杆菌科细菌对碳青霉烯类抗菌药物、革兰阳性球菌对糖肽类抗菌药物100.0%敏感;MRSA和MRCNS检出率分别为40.00%、35.3%。结论尽管医院细菌耐药率明显低于三甲医院细菌耐药率,但仍不可忽视细菌耐药性的动态监测,力图减缓细菌耐药性增长速度。

OBJECTIVE To approach the distribution and drug resistance of the pathogenic bacteria causing nosocomial infections in the hospital in 2011 so as to provide basis for the reasonable clinical use of antibiotics.METHODS The bacterial isolation and identification were performed by referring to National Guide to Clinical Laboratory Procedures（Third Edition）.The susceptibility testings were performed by K-B methods.The testing results were assessed according to CLSI 2011 breakpoints.RESULTS Of totally 454 strains of pathogens isolated in 2011,the detection rate of the gram-negative bacilli was the highest（71.4%）,followed by the gram-positive cocci（21.6%） and fungi（7.0%）.The pathogenic bacteria was resistant to antibiotics in varying degree except for Proteus.The drug resistance rate of carbapenems against Pseudomonas aeruginosa was 7.7%,100.0% of Enterobacteriaceae were sensitive to carbapenem antibiotics,and 100.0% of gram-positive cocci were sensitive to glycopeptide antibiotics.The methicillin-resistant Staphylococcus aureus（MRSA） and coagulase-negative Staphylococcus（MRCNS） accounted for 40.0% and 35.3%,respectively.CONCLUSION Although it is of the lower drug resistance rate of the bacteria in the third-level grade-A hospital than in the hospital investigated,yet the dynamic monitoring of bacterial resistance can not be neglected,and the hospital should try to slow down the growth of bacterial resistance.