163株多重耐药菌检出情况分析

Analysis of multidrug-resistant organisms of 163 strains in this hospital

目的了解宾阳县妇女儿童医院多重耐药菌种类及分布情况,为临床治疗和控制医院感染提供依据。方法使用湖南天地人TDR-200B微生物分析仪进行菌种鉴定和药敏试验,对分离到的多重耐药菌的分布进行分析。结果共分离出病原菌728株,多重耐药菌163株,占22.4%;163株多重耐药菌中革兰阳性菌占14.7%,革兰阴性菌占85.3%,以产超广谱β-内酰胺酶细菌居多,占72.4%,其次为耐甲氧西林金黄色葡萄球菌,前3位为肺炎克雷伯菌、大肠埃希菌、金黄色葡萄球菌。临床各科室主要分布:儿科50.3%,新生儿科17.8%,外科14.1%,成人内科11.0%,妇科3.7%,产科3.1%。年龄最大84岁,最小2d,3个月至1岁占62%。多重耐药菌大多来源于痰标本,占所有分离标本的68.7%。结论宾阳县妇女儿童医院引起医院感染部位多发生在下呼吸道,以产ES-BLs的细菌为主,临床应合理使用抗菌药物,加强对小儿肺炎的多重耐药菌的监测与控制,特别要关注泛耐药的产生与流行。

Objective To investigate the distribution of multidrug- resistant organisms （MDRO） with various resistance to provide scientific basis for the establishment of effective medical protection and control measures and to provide useful information for clinical management. Methods The medical sensitivity and identification of the isolated MDRO were determined by TDR-200B. Results A total of 163 strains of MDRO were isolated from 728 strains of pathogenic bacteria, of which the G＋ were 14.7% and the G were 85.3%. The top 3 pathogens were Klebsiella pneumoniae, Escherichia coli and methicillin resistant Staphylococus aureus （MRSA）. Infected individuals distribu- ted mainly in Pediatric （50.3%）, New pediatric （17.8%）, Surgery （14.1%） ,Adult Medical （11.0%）, Gynecologi- cal （3.7%） and Obstetrics （3.1%）. The oldest of the cases was 84, the youngest was 2 days, and 62% of the cases were 3 months to one year. Most of MDRO were from the sputum sample. Conclusion The main hospital infection could be in respiratory tract. The effective measures and reasonable use of antibiotics should be taken to control the infection caused by MDRO in children pneumonia, and more attention should be paid on the occurrence and preva- lence of pandrug resistant strains.