医院多重耐药菌感染监测及分析

Surveillance and analysis of MDRB infection in hospital

目的回顾性分析承德市中心医院临床分离多重耐药菌(multi-drug resistant bacterium,MDRB)感染情况及耐药性,为临床有效控制MDRB感染提供依据。方法对本院2008年-2012年检测到的MDRB进行分析,采用梅里埃ATB系统鉴定,K-B纸片扩散法进行药敏试验,按CLSI2010年标准判读药敏试验结果,采用WHONE5.4软件进行数据分析。结果耐甲氧西林金黄色葡萄球菌(MRSA)检出率为52.2%,未发现对万古霉素、利奈唑胺耐药金黄色葡萄球菌;2012年检测到2例万古霉素耐药肠球菌,均为屎肠球菌;大肠埃希菌、肺炎克雷伯杆菌、奇异变形杆菌中超广谱β-内酰胺酶(ESBLs)检出率分别为32.9%(477/1452)、20.0%(103/516)、14.8%(28/189),未发现对亚胺培南耐药肠杆菌。结论 5年来本院MDRB发生呈上升趋势,耐药性较严重。须加强MDRB监测,同时采取切实有效措施控制MDRB院内传播和暴发流行。

Objective To retrospectively analyze the MDRB infection status of clinical isolates and drug resistance in Chengde central hospital, in order to provide an effective basis for control of MDRB nosocomial infection. Methods MDRB isolates in Chengde central hospital from 2008 to 2012 were identified by Biomerieux ATB expression system, and conducted antibiotic sensitivity test by Kirby - Bauer method. The outcome of antimicrobial susceptibility testing was judged in accordance with CLSI2010. WHONET 5.4 software was employed for statistical analysis. Results The positive rate of methicillin - resistant S. aureus（MRSA） was 52.2% ; No staphylococcus （S. aureus） strains were found resistant to vancomycin or linezolid. Two E.faecium strains were found resistant to vancomycin in 2012. ESBLs - producing strains accounted for 32.9%, 20.0% and 14.8% respectively in E. coli, K. pnettmoniae and P. mirabilis. No enterococcus strains were found resistant to imipenem （IPM）. Conclusion Multi - drug resistance bacteria was on the rise in the past 5 years accompanying by serious drug resistance, so MDRB monitoring should be strengthened to control nosocomial infections and outbreak of MDRB.