多药耐药菌监测分析及预防控制对策

Monitoring and control strategies of multidrug-resistant organisms

目的了解医院多药耐药菌(MDROs)的分布状况,促进抗菌药物合理应用,为医院感染控制措施的制定提供依据。方法对2010年1月-2011年12月住院患者送检标本中分离出的多药耐药菌株进行统计分析。结果共分离出病原菌2538株,其中多药耐药菌株841株,占33.14%,主要来自痰液,占48.75%,其次为尿液及分泌物,分别占26.87%、14.03%;耐药菌株中大肠埃希菌居第1位,占38.05%,耐甲氧西林金黄色葡萄球菌占25.21%,铜绿假单胞菌占18.19%;ICU MDROs感染比例最高,共分离出287株,占34.13%,其次是泌尿外科及烧伤科,分别占8.68%和6.54%。结论在多药耐药菌感染预防控制中,应加强细菌耐药性监测,重点关注ICU及呼吸系统多药耐药菌感染的预防控制工作,规范抗菌药物应用,制定并执行切实可行的综合性预防控制措施。

OBJECTIVE To promote the rational use of antibiotics and provide the reference for the formulation ofnosocomial infection control measures through understanding the distribution of multidrug-resistant organisms（MDROs）. METHODS The MDROs strains isolated from the submitted specimens obtained from the patients whohospitalized from Jan 2010 to Dec 2011 were statistically analyzed. RESULTS Of totally 2538 strains of pathogensisolated, there were 841 （33. 14%） strains of MDROs, among which 48. 75% were isolated from the sputum,followed by the urine （26. 87%） and the secretions （14. 03%）. Among the MDROs strains, the Escherichia coliranked the first place and accounted for 38. 05%,methicillin-resistant Staphylococcus aureus accounted for26.87%,Pseudomonas aeruginosa accounted for 18. 19%. The incidence of MDROs infections was the highest inthe ICU where 287 （34. 13%） strains were isolated,followed by the urology department （8. 68%） and the burndepartment （6. 54%）. CONCLUSION It is necessary to strengthen the surveillance of bacterial resistance in theprevention and control of MDROs infections through focusing on the prevention and control of MDROs infectionsin ICU and respiratory departments, regulating the rational use of antibiotics,setting and implementing practicalcomprehensive prevention and control measures, so as to prevent and control the MDROs infections.