医院感染常见病原菌分布及耐药性分析

Distribution and drug resistance of common pathogens causing nosocomial infections

目的对医院感染常见病原菌的耐药特点进行总结,以制定有针对性的抗菌药物应用策略,为临床合理用药提供参考。方法对医院感染的标本进行病原菌培养与药敏检查,并对其检查结果进行总结分析,观察医院感染常见耐药菌分布及其耐药特点。结果共分离出耐药菌426株,前10位主要病原菌以革兰阴性菌为主,其中大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、肺炎链球菌、鲍氏不动杆菌分别占9.62%、6.81%、6.34%、6.10%、4.93%;产ESBLs大肠埃希菌检出率最高为73.17%,其次为耐甲氧西林表皮葡萄球菌71.43%、产ESBLs肺炎克雷伯菌62.07%,革兰阳性菌中金黄色葡萄球菌、肺炎链球菌对红霉素的耐药率最高,分别为61.11%、61.54%,革兰阴性菌中大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌对氨苄西林的耐药率最高,分别为26.83%、31.03%、47.62%。结论临床上要提高对医院感染的认识,尽量避免其发生,同时注意监测其细菌耐药特点,重视药敏检查,提高临床抗菌药物应用的合理性,在保证临床疗效的同时,减少多药耐药菌的发生。

OBJECTIVE To summarize the characteristics of drug resistance of the pathogens causing nosocomial infections so as to put forword tarqeted for the use of antibiotics. METHODS The specimens of nosocomial infections were treated with the bacterial culture and drug sensitive test, and the types and resistance characteristics of the common drug resistant bacteria were analyzed. RESULTS A total of 426 drug-resistant strains were isolated. The most common spelies were Escherichia coli （9.62 % ）, Klebsiella pneumoniae （6.81% ）, Pseudomonas aeruginosa （6. 34 % ）, Streptococcus pneumoniae （ 6. 10 ~/00 ） , and Acinetobacter baumannii （4.93 % ）. The resistance rate of E. coli （72.48%）was the highest, followed by S. epidermidis （67.53%）, K. pneumoniae （60.92 %）. Among gram positive bacteria, S. aureus and S. pneumonia showed higher resistance to erythromycin （61.11%, 61. 54% respectively） ~ among gram-negative bacteria, E. coli, K. pneumonia, and A. baumannii showed higher resistance to ampicillin （26.83 %, 31.03 %, 61.54 %, 47.62 ~, respectively）. CONCLUSION Much attention should be paid to the knowledge of nosocomial infections, at the same time, it is also important to monitor the characteristics of bacterial resistance, emphasize on drug susceptibility, and improve the rationality of use of antibiotics, and minimize the bacterial resistance.