临床分离多重耐药菌感染特点及耐药性研究

Research on characteristics and drug resistance of clinical separated multi-drug resistent organisms infection

目的研究临床分离多重耐药菌(MDRO)感染特点及其耐药性,为临床感染预防与控制提供参考。方法通过细菌分离鉴定技术和药敏试验方法,对某医院住院患者送检标本进行病原学检测与临床分析。结果该医院在2012年度从感染病人送检标本中共检出MDRO 1 341株,以产超广谱β-内酰胺酶(ESBLs)大肠埃希菌、肺炎克雷伯菌和耐甲氧西林金黄色葡萄球菌(MRSA)分居前3位,构成比分别为43.92%、28.19%和13.20%。检出的MDRO中,有63.61%分离自痰液、咽拭子及肺部灌洗液标本,显示以呼吸道感染为主。MDRO感染例数最多的科室依次为儿科、呼吸内科、ICU、老年病科和泌尿外科。MDRO对β-内酰胺类、β-内酰胺酶抑制剂、氨基糖苷类、喹诺酮类、头孢类、磺胺类、碳青霉烯类均有不同程度耐药。结论该医院MDRO感染以呼吸道为主,耐药严重,应根据药敏结果合理选用抗菌药物作为重点防控措施。

Objective To explore the infection characteristics and drug resistance of clinical separated multi - drug resis- tent organisms （ MDRO）, so as to provide reference for clinical infection prevention and control. Methods Bacteria sepa- ration identification technology and drug sensitive test were used to do pathogen detection test and clinical analysis of a hos- pital patients＇ samples. Results In 2012, 1 341 strains of MDRO were detected from patients infected in the hospital, the top 3 were extended - spectrum [3 - lactamases（ESBLs） - producing Escherichia coli, Klebsiella pneumoniae and methi- cillin- resistant Staphylococcus aureus （MRSA）, the constituent ratio was 43.92%, 28. 19% and 13.20% respective- ly. 63.61% of MORD were isolated from sputum, swabs, and lung lavage fluid specimens which showed mainly from respir- atory tract. Most of MDRO infection occurred in the department of pediatrics, respiratory medicine, ICU and geriatrics and urology. MDRO had different degree of drug resistance to beta lactam, beta lactamase inhibitor, aminogly coside, quinolo- ne, cephalosporins, sulfa and carbon penicillium alkene. Conclusion The hospital MDRO infection is mainly from respir- atory tract, drug resistance is serious. Rational use of antimicrobial drugs according to the results of drug sensitivity was the key prevention and control measures.