传染病医院病原菌监测分析及多药耐药菌控制措施的评价

Analysis of pathogen detection in hospital for infectious diseases and evaluation of control measures of multi-drug resistant organisms

目的:了解传染病专科医院病原菌及其耐药情况,并通过对多药耐药菌(MDROs)的控制措施的评价,为临床合理用药及有效控制提供可靠的理论依据。方法:收集医院微生物实验室所有类型标本中检出的病原菌及MDROs,及对每例MDROs控制措施情况的资料,分析病原菌的构成分布及耐药性,对比2年对MDROs控制措施的改进状况。结果:医院检测的病原菌中以革兰阴性的大肠埃希菌、肺炎克雷伯菌及革兰阳性的葡萄球菌属、酵母菌属为主,且耐药情况严重。2年耐药菌检出率的差异无显著性(x2=0.131,P>0.05),对MDROs控制措施的改进状况明显(x2=5.815,P<0.05)。结论:医院检出病原菌耐药情况较严重,对MDROs的控制措施明显改善,但短时间内(2年)比较,全院耐药菌检出率的差异无显著性变化,尚需持续加强抗菌药物合理应用监管,及进一步做好MDROs的各项控制措施。

ObjectiveTo study pathogens and drug resistance status in a hospital for infectious diseases and evaluate controlmeasures of multi-drug resistant organisms （MDROs） so as to provide a reliable theoretical basis for rational drug use and effectivecontrol. Methods：The detected pathogens and MDROs in the microbiological laboratory and the corresponding control measures ofMDROs were collected to analyze the composition and distribution of the pathogens and their drug resistance. Then, the control meas-ures of MDROs in two years were compared. Results： The detected pathogens in the hospital were mainly gram-negative escherichia co-li, klebsiella pneumoniae, gram-positive staphylococcus, and Saccharomyces, and their drug resistance was in a serious condition. Nosignificant difference in the detection rate of drug resistance between the twp years （x2 =0. 131, P〉0. 05）. The improvement of thecontrol measures of MDROs was significant （x2 =5. 815, P〈0. 05）. Conclusions： The drug resistance of the pathogens in the hospitalis more serious, and the control measures of MDROs are markedly improved. But within a short time （2 years） （for comparison）, thedifference of the detection rates of drug -resistant bacteria is insignificant. Therefore, it is needed to continue strengthening the rationaluse of antibiotics and further improve the control measures of MDROs.