医院感染细菌的临床分布及耐药性分析

Clinical distribution and antibiotic resistance analysis on bacteria of nosocomial infection

目的了解医院感染细菌在临床科室和标本中的分布及耐药情况。方法回顾性分析2011年1月～2011年12月本院感染菌的分布及耐药情况。使用法国生物-梅里埃ATB细菌鉴定系统,应用药敏测试仪及配套微生物检测试剂进行细菌鉴定和药敏试验。结果本研究分离的455株感染菌中,大肠埃希菌、肺炎克雷伯菌、白假丝酵母菌、表皮葡萄球菌、鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌7种细菌是医院主要感染菌,占检出菌的68.13%。检出耐甲氧西林金黄色葡萄球菌(MRSA)及表皮葡萄球菌(MRSE)分别占46.43%及75.68%,未发现耐万古霉素和替考拉宁的葡萄球菌。多重耐药菌38例,阳性率8.35%。鲍曼不动杆菌中检出37.93%(11/29)的多重耐药菌株。细菌来源以呼吸内科和ICU为主,各类标本中以痰标本所检出阳性细菌最多,共178株(39.12%)。结论定期进行耐药性监测有助于了解医院细菌耐药性的变迁,为临床经验用药提供理论依据。

Objective To investigate the distribution and antibiotic resistance of hospitalized infection bacteria in clinical departments and specimens. Methods French biology-bioM6rieux ATB bacterial identification system, susceptibility detection instrument and supporting microbial detection reagent were applied for bacterial identification and susceptibility testing. The distribution of bacterial infection and antibiotic resistance data from January 2011 to December 2011 were analyzed, respectively. Results Among 455 bacteria, Escherichia coli, Klebsiella pneumoniae, Candida albicans, Staphylococcus epidermidis, Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus were the seven major infection bacteria, accounting for 68.13% of the total detected bacteria. Methicillin-resistant Staphylococcus aureus （MRSA） and Staphylococcus epidermidis （MRSE） were with 46. 43% and 75. 68% detection, no vancomycin-resistant and teicoplain-resistant Staphylococcus aureus were detected. There were 38 cases with multiple antibiotic resistant bacteria with positive rate as 8.35%. There was 37.93% （11/29） Acinetobacter baumannii detected as pan-resistant bacteria. The sources of bacterial were mainly from respiratory medicine and intensive care unit （ICU）. Sputum samples had the highest positive bacteria with 178 （39. 12% ）. Conslusions That conducting regular surveillance of antibiotic resistance could help analyze changes of antibiotic resistant of hospital bacteria, providing a theoretical basis for the clinical experience of drug use.