某三甲医院切口分泌物细菌分布及其耐药性分析

Distribution and drug resistance analysis of the bacterial in the incision secretion of an 3 armour hospital

目的了解该院外科手术患者切口分泌物细菌分布情况及其耐药状况,为临床合理运用抗生素及控制院内感染提供依据。方法使用商品诊断试剂做细菌鉴定及药物敏感试验,药物敏感试验为微量肉汤稀释法;耐药性数据用LIS系统统计。结果 (1)共分离菌株588株,其中革兰阳性菌238株(40.5%),革兰阴性菌350株(59.5%);分离率最高的前6位病原菌依次为金黄色葡萄球菌(17.0%)、大肠埃希菌(11.9%)、粪肠球菌(8.8%)、铜绿假单胞菌(8.5%)、鲍曼不动杆菌(6.1%)。(2)耐甲氧西林金黄色葡萄球菌和表皮葡萄球菌检出率分别为15.7%与77.8%。粪肠球菌对替考拉宁耐药率为3.8%;未发现对万古霉素耐药的肠球菌。大肠埃希菌、肺炎克雷伯菌超广谱β-内酰胺酶(ESBLs)检出率分别为65.71%、9.09%。结论该院外科切口分泌物致病菌以金黄色葡萄球菌、大肠埃希菌为主,细菌耐药严重,应定期进行耐药性分析,制定用药策略,临床应该加强预防医院感染管理,减少院内感染的发生。

Objective To investigate distribution and drug resistance status of the bacterial in the incision secretion of surgical patients, and to provide a basis for clinical rational use of antibiotics and control of nosocomial infection. Methods Bacteria identification and drug sensitive test were conducted by applying commodity diagnosis reagent, trctee broth dilution method for drug sensitive test, and LIS system data statistics for tolerance. Results 588 strains were separated,in which 238 strains （40.5 % ） were gram positive bacteria,350 strains （59.5%） were negative; The top 6 kinds of pathogenic bacteria were staphylococcus aureus （ 17.0% ） , eseheriehia eoli （ 11.9 % ）, dung enteroeoccus （ 8.8% ）, pseudomonas aeruginosa （ 8.5 % ）, aeinetobacter baumannii （ 6.1% ） in turn. Detection rates of methieillin-resistant staphylococcus anreus and staphylococcus epidermidis were 15.7% and 77.8% respectively. Resistance rates of dung enterococcus to TiKao was 3.8% ;the vancomycin-resistant enterocoeeus not found. Detection rates of bacteria super broad-spectrum beta-laetamase （ESBLs） in Escheriehia eoli and klebsiella pneumoniae were 65.71% and 9.09% respectively. Conclusions The path- ogenie baeteria in the surgical incision secretion of the hospital＇ s patients are dominately Staphylococcus aureus and Eseherichia coli. Bacterial resistance is serious condition, so analysis of drug resistance should be carried out regularly, and drug development policies should be made. Management of nosoeomial infection prevention should be strengthend to reduee the incidence of nosoeomial infections.