妇幼专科医院病原体菌群分布及耐药分析

Bacterial pathogen distribution and drug resistance analysis of maternal and child hospital

目的对送检标本中分离的致病菌分布及耐药趋势进行分析,旨在做好防控措施和指导临床合理使用抗菌药物。方法进行常规培养分离鉴定,药敏试验应用K-B纸片扩散法,按CLSI/NCCLS规定的标准进行。结果 3年共分离到1071株细菌,其中G+菌414株,占38.65%,G-菌465株,占43.41%。MRSA检出率明显上升,分别为:3%、9%、13%。纳入目标性监测的多重耐药菌(MDRO)包括:耐甲氧西林金黄色葡萄球菌(MRSA)20株、多重耐药的大肠埃希菌25株、多重耐药的肺炎克雷伯菌4株、耐万古霉素肠球菌(VRE)1株、多重耐药的铜绿假单胞菌1株。2013年金黄色葡萄球菌开始出现万古霉素耐药株,耐药率为16%。结论妇幼专科医院病原菌群相比综合医院病种少,病原菌也相对较少,但是病原菌群也同样随着时间推移在不断变迁,耐药性逐年增长,加强监测防控,指导临床合理用药也很有意义。

Objective To analyze the distribution of pathogenic bacteria isolated from specimens and the drug resistance tendency , so as to make prevention and control and guide rational use of antimicrobial drugs .Methods Conventional culture isolation , identification and susceptibility testing were done with K-B disk diffusion method according to standard CLSI /NCCLS requirement .Results In these three years totally 1 071 bacteria were isolated, including 414 G＋strains （38.65%） and 465 G-strains （43.41%）.The positive rate of MRSA increased significantly , and they were 3%, 9%and 13%, respectively .The multiple resistant bacteria （ MDRO） with targeted monitoring included methicillin-resistant staphylococcus aureus （MRSA, 20 strains）, multi-drug resistant Escherichia coli （25 strains）, multi-drug resistant klebsiella pneumoniae （ 4 strains ） , vancomycin-resistant enterococci （ VRE, 1 strain ） and multi-drug resistant pseudomonas aeruginosa aeromonas （ 1 strain ） .In 2013 vancomycin resistant strains were found in staphylococcus aureus , and the resistant rate was 16%.Conclusion Compared with comprehensive hospitals , the pathogen groups and pathogens are less in maternal and child hospitals . However, the pathogen groups constantly change over time and drug resistance grows year after year .Strengthening monitoring and prevention to guide rational drug use in clinics is also important .