某三甲中医院临床多重耐药菌分析及管理对策

Analysis and Management Countermeasures of Clinical Multi-drug Resistant Bacteria in A Tertiary Traditional Chinese Medicine Hospital

目的:了解医院多重耐药菌分布及耐药情况,为合理使用抗菌药物、减低医院感染提供依据。方法:收集2010年1月1日-2012年12月31日临床感染药敏资料,统计多重耐药菌及前10位多重耐药菌耐药率。结果:共调查多重耐药标本1049例,其中痰标本447例,占42.61%;其他依次为分泌物、尿、便。革兰氏阳性菌586例,占55.86%,革兰氏阴性菌463例,占54.14%。前五位耐药菌为耐甲氧西林凝固酶阴性葡萄球菌、嗜血杆菌、屎肠球菌、棒状杆菌、肺炎链球菌,均为普通菌。结论:普通菌已成为常见的多重耐药菌,对"非限制使用"、"限制使用"抗菌药物具有普遍耐药性,临床必须根据药敏情况谨慎选择抗菌药物,同时注意药物体内外效应的一致性。加强每个防控细节管理,能够有效防止医院多重耐药菌感染。

Objective：To investigate the distribution and resistance of Multi-drug resistant bacteria,and provide the basis for rational use of antibacterial and reduce the hospital infection.Method：Collected the clinical infection drug sensitivity data from January 1,2010 to December 31,2012,and gathered statistics of the multi-drug resistant bacteria and the resistance rate of the top 10 multi-drug resistant bacteria.Result：A total of 1049 cases of Multi-drug resistant bacteric were investigated,including sputum（447 cases,account for 42.61%）,secretions,urine and feces.In those cases that were 586 cases of gram-positive bacteria（account for 55.86%）,and gram-negative bacteria were 463 cases（account for 54.14%）.The top five multi-drug resistant bacteria were methicillin resistant coagulase negative staphylococcus（MRCNS）,haemophilus,enterococcus faecium,corynebacterium,streptococcus pneumonia,which were all common bacteria.Conclusion：Common bacteria have become common in multiple drug-resistant bacteria.For the use of unrestricted and restrict antimicrobial agents,they have universal resistance.And the clinical antimicrobial agents should be chosen carefully on the base of drug sensitivity,while paying attention to the consistency of drugs effects in internal and external.It can effectively prevent multi-resistant infections in hospital by strengthening each detail of prevention and control management.