7所地方综合性医院感染病原体及其耐药性分析

Analysis of Pathogen Intection and Drug Resistance in Seven Local Hospitals

目的分析咸阳市区7所二级以上综合性医院医院感染病例分离的病原体构成及对常见抗菌药物的敏感性。方法收集2011年1～6月份目标医院所有科室医院感染病例分离的病原体及耐药监测数据,使用WHO-NET5.6软件进行统计分析。采用K-B纸片扩散法或微量肉汤稀释法进行抗菌药物敏感试验。其判定标准依据美国临床实验室标准化研究所(CLSI)规定,结果共分离病原体142株,G-菌占59.86%,G+菌和真菌分别占35.92%和4.22%。凝固酶阴性葡萄球菌居首位。耐甲氧西林的金黄色葡萄球菌检出率达100%,耐甲氧西林的凝固酶阴性葡萄球菌占17.4%,未发现金黄色葡萄球菌和凝固酶阴性葡萄球菌对万古霉素、呋喃妥因、利奈唑胺耐药;肠杆菌科细菌对碳青酶烯类抗菌药物、哌拉西林/他唑巴坦耐药率为0～16.7%,对其它多数药物耐药率在50%以上。鲍曼不动杆菌对哌拉西林/他唑巴坦耐药率在9.1%,对碳青霉烯类抗菌药物保持好的敏感性,未见耐药菌株出现。结论医院感染病原菌耐药现象十分普遍,应加强细菌学检验,及时了解其耐药性变迁,以便指导临床合理用药,有效控制医院感染。

Objective analysis of the infection cases isolated pathogens constitute Xianyang seven general hospitals for more than two common antimierobial sensitivity. Methods 2011 jan - June target hospitals hospital infections i- solated pathogens and drug resistance surveillance data of all departments, use WHONETS. 6 software for statistical analysis. KB disk diffusion method or the broth microdilution method for antimicrobial susceptibility testing. Deter- mining standards in accordance with the provisions of the American Society for Clinical Laboratory Standards Institu- te （CLSI）. Results were isolated pathogens 142, G-bacteria accounted for 59.86% G ＋ bacteria and fungi accoun- ted for 35.92% and 4.22% respectively. Coagulase - negative staphylococci first place. 100% detection rate of me- thicillin- resistant Staphylococcus aureus, methicillin- resistant coagulase- negative staphylococci accounted for 17.4% ,not found in Staphylococcus aureus and coagulase- negative staphylococci to vancomycin, nitrofurantoin, linezolid the acetazolamide resistance; Enterobacteriaceae carbapenem antibacterial drugs, piperacillin/tazobaetam resistance rate from 0 to 16.7% ,most other drug resistance rates above 50%. Acinetobacter baumannii in 9.1% topiperacillin/tazobactam resistance rates to maintain good sensitivity carbapenem antibacterial drugs, no drug -resist- ant strains. Conclusion hospital infection resistant pathogens is widespread bacteriological examination should be strengthened, to keep abreast of its resistance to change, in order to guide rational drug, effective control of hospital infection.