2011年～2013年某院多重耐药菌的监测与分析

The Monitoring and Analysis of Multi-resistant Bacteria in A Hospital From 2011 to 2013 Years

目的了解本院多重耐药菌种类及分布情况,为临床治疗和控制医院感染提供依据。方法采用K-B法或ATB细菌鉴定分析仪,依据CLSI2010年标准进行鉴定和药物敏感试验。结果共分离到7681株细菌,以革兰阴性杆菌为主共5670株占74.0%,革兰阳性菌株1046株占13.7%,真菌940株(12.3%)。共分离出多重耐药菌968株,前5位多重耐药菌依次为产ESBLs大肠埃希菌共516株(53.3%)、非产酶大肠埃希菌169株(17.5%),产ESBLs肺炎克雷伯菌112株(11.6%),耐苯唑西林葡萄球菌(MRCNS)94株(9.7%),耐苯唑西林金黄色葡萄球菌(MRSA)76(7.9%),主要是分布在外科、儿科、ICU和内科。在标本分布中,居于前3位的标本是以儿科、ICU、内科痰液为主,共检出353株(36.5%),其次是外科腹腔脓液为主,共249株(25.7%)。结论我院引起医院感染部位多发生在脓液和下呼吸道,以产ESBLs的细菌为主,临床应合理使用抗菌药物,加强对外科、儿科和ICU等科室多重耐药菌的监测与控制,以减少多重耐药菌感染的发生及蔓延。

Objective To understand our multiple drug-resistant strains of type and distribution, provide the basis for clinical treatment and control of hospital infection. Methods Using K-B or method of ATB bacteria identification analyzer, according to the standard for identification and drug sensitive test CLSI2010 years. Results 7681 strains bacteria isolated, mainly gram-negative bacilli 5670 strains （74.0%）, gram positive strains in 1046 strains （13.7%）, fungus 940 strains （12.3%）. A total of 968 strains of multi-resistant bacteria was isolated, top 5 of multi-resistant bacteria produce ESBLs e. coli, a total of 516 strains （53.3%）, the enzyme production, E.coli 169 strains （17.5%）, producing ESBLs 112 strains （11.6%）, pneumonia klebsiella bacteria resistant to benzene azole Westwood staphylococcus （MRCNS）, 94 strains （9.7%）, benzene azole resistance Westwood staphylococcus aureus （MRSA）, 76 （7.9%）, mainly distributed in surgery, pediatrics, ICU, and medicine. On the distribution of the specimen, the top three specimens in pediatrics, ICU, internal sputum is given priority to, cheek out the 353 strains （36.5%）, followed by surgical abdominal pus is given priority to, a total of 249 strains （25.7%）. Conclusion Our position causes the hospital infection in pus and lower respiratory tract, give priority to with producing ESBLs bacteria, clinical should be rational use of antimicrobial agents, strengthen the surgery, pediatrics and ICU department of multi-resistant bacteria such as monitoring and control, to reduce the infection outbreak and spread of multi-resistant bacteria.