我院2012年医院感染病原菌分布及耐药性分析

Analysis of the Distribution and Drug Resistance of Nosocomial Infection Pathogens in Our Hospital in 2012

目的:掌握医院感染病原菌临床分布特点和耐药性,为合理使用抗菌药物和预防医院感染提供依据。方法:回顾性分析2012年医院感染资料,并将信息录入到EpiData3.0建立的数据库;采用描述性方法描述医院感染病原菌的临床分布及耐药资料,利用SPSS17.0进行χ2检验及Fisher精确概率法。结果:2012年共发生医院感染413例,有171例经病原学证实,占41.4%。居医院感染前5位的病原菌是大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、金黄色葡萄球菌和肺炎克雷伯菌。医院感染病原菌在各科室均有检出,但以神经外科和普外科居多;检出病原菌的标本以尿、痰和分泌物居多。前5位医院感染病原菌均有敏感的抗菌药物,分别是美罗培南、多粘菌素、米诺环素、万古霉素和利奈唑胺、美罗培南和左氧氟沙星。但是大多数抗菌药物的耐药率达30%以上,部分抗菌药物更可达90%以上。结论:医院感染病原菌常分布于呼吸道、泌尿道和神经外科、普外科,应加强对重点部位、重点环节及高发科室的监控力度;主要医院感染病原菌对大多数抗菌药物耐药,应加强病原菌检查及药敏监测,指导临床合理选择抗菌药物。

OBJECTIVE：To acquire the clinical distribution and drug resistance of nosocomial infection pathogens,so as to provide reference for the prevention of nosocomial infection and rational use of antibiotics.METHODS：The data of nosocomial infection in 2012 were reviewed and input into database which was built by EpiData 3.0;the descriptive method was used for describing clinical distribution and drug resistance of nosocomial infection pathogens.Chi square test and Fisher exact probability were conducted by SPSS 17.0 software.RESULTS：There were 413 cases of nosocomial infection in 2012,and 171 cases had been confirmed by etiology,accounting for 41.4%.The main pathogenic bacteria in nosocomial infection were Escherichia coli,Pseudomonas aeruginosa,Acinetobacter baumannii,Staphylococcus aureus and Klebsiella pneumoniae.Pathogens of nosocomial infection were detected in most departments,especially in department of neurosurgery and general surgery.The major strains were isolated from sputum,urine and secretion.The top 5 pathogens were all sensitive to some antibiotics,such as meropenem,polymyxin,minocyline,vancomycin and linezolid,meropenem and levofloxacin.But the resistance rate of most antibiotics was more than 30%,that of some antibiotics could be more than 90%.CONCLUSIONS：Nosocomial infection pathogens often distribute in respiratory tract,urinary tract and neurosurgery department,general surgery department.So we should strengthen the monitoring work on key parts,key link and the high-risk departments;major nosocomial infection pathogens are resistant to most antibiotics.The pathogens test and drug susceptibility monitoring should be strengthened so as to guide clinical rational selection of antibiotics.