综合医院医院感染病原菌耐药性分析及预防控制的意义

Drug resistance of pathogens causing nosocomial infections in a general hospital and significance of prevention and control

目的了解2012年全年综合医院医院感染病原菌分布及耐药性,为预防和控制医院感染及抗菌药物应用提供可靠依据。方法采用法国生物梅里埃公司VITEK-2Compact全自动细菌鉴定仪及配套鉴定卡、药敏试验卡对分离出的医院感染病原菌进行鉴定及耐药性分析。结果 2012年全年发生医院感染1 552例,主要分布在神经外科、普通外科、保健医疗部及血液科,分别占17.95%、13.98%、11.28%及6.51%;1 552例医院感染患者共分离出病原菌1 399株,其中革兰阴性菌971株占69.41%,革兰阳性菌381株占27.23%,真菌47株占3.36%;革兰阴性菌有多药耐药趋势,其中以大肠埃希菌最为显著,鲍氏不动杆菌对头孢哌酮/舒巴坦的敏感率为86.24%;革兰阳性菌对万古霉素及利奈唑胺的敏感率仍保持在100.00%。结论医院感染病原菌耐药性非常严重,应加强病原菌分布及耐药性监测,重视消毒隔离措施,同时也要注意抗菌药物的规范应用。

OBJECTIVE To explore the distribution and drug resistance of pathogens causing nosocomial infections in a general hospital in 2012 and put forward measures for prevention and control of the nosocomial infections so as to provide reliable basis for use of antibiotics.METHODS The isolated pathogens causing nosocomial infections were identified by using VITEK-2Compact automatic bacterial identification system of BioMérieux of France and matched identification cards;the drug susceptibility testing was performed with the use of drug susceptibility testing card.RESULTS The nosocomial infections occurred in 1 552 cases in the whole year of 2012,among whom17.95% distributed in the department of neurosurgery,13.98%in the department of general surgery,11.28%in the health care medical department,6.51%in the department of hematology.A total of 1 399 strains of pathogens have been isolated from the 1 552 patients with nosocoial infections,including 971（69.41%）strains of gram-negative bacteria,381（27.23%）strains of gram-positive bacteria,and 47（3.36%）strains of fungi.The gram-negative bacteria showed the tendency of multidrug-resistance,the Escherichia coli the most prominent,and the drug susceptibility rate of the Acinetobacter baumannii to cefoperazone-sulbactam was 86.24%;the drug susceptibility rate of the gram-positive bacteria to vancomycin and linezolid remained at 100.00%.CONCLUSION The drug resistance of the pathogens causing the nosocomial infections has become very serious.It is necessary to strengthen the monitoring of the distribution and drug resistance of the pathogens,focus on the disinfection and isolation,and pay attention to the reasonable use of antibiotics.