高原地区医院感染病原菌的分布及耐药分析

Distribution and drug resistance analysis of hospital infection pathogenic bacteria in the highland areas

目的：分析格尔木市人民医院2013年度住院患者医院感染中分离出的病原菌分布及耐药性。方法：对我院2013年度临床分离的105株感染菌作回顾性分析。采用山东鑫科细菌鉴定培养仪，用MIC法进行药物敏感性试验。结果：医院的感染病例中共分离出105株致病菌，其中，革兰氏阴性细菌98株，占93.33%；阳性细菌7株，占6.66%；革兰氏阴性杆菌以大肠埃希菌（35.23%）、阴沟肠杆菌（16.19%）、肺炎克雷伯菌（13.33%）为主；革兰氏阳性菌以金黄色葡萄球菌（1.90）、凝固酶阴性葡萄球菌（1.90%）、肠球菌属（1.90%）为主；采集标本占前三位的分别是血液（22.85%）、下呼吸道标本（18.09%）、分泌物（13.33）；在革兰氏阴性细菌中耐药率居首的为大肠埃希菌、肺炎克雷伯菌，对碳青霉烯类亚胺培南的敏感率达100%；在革兰氏阳性细菌中葡萄球菌属对青霉素的耐药率达100%，未出现万古霉素耐药。肠球菌属对青霉素耐药率达100%，未出现万古霉素耐药。结论：医院感染中革兰氏阴性细菌感染率较高，某些条件致病菌的检出率增多，且对常用抗菌药物耐药性高，降低医院感染发生率，减少医院感染病原菌，重视病原菌培养，合理使用抗菌药物，控制医院感染具有重要意义。

Objective：This thesis purposes to analyze the distribution and drug resistance of pathogenic bacteria isolated from 2013 Annual inpatient hospital infection cases in Golmud RenMin Hospital. Methods：The research method is applying a retrospective analysis to clinical isolates of 105 bacterial infection in our hospital 2013.And with the help of Shandong Xinke identification of bacteria culture instrument,the drug susceptibility was tested by MIC method.Results：The results show that among the 105 strains of pathogenic bacteria isolated from hospital infection cases, Gram-negative bacteria hold 98, accounting for 93.33%; positive bacteria 7, accounting for 6.66%. Gram-negative bacteria are dominated by Escherichia coli （35.23%）, Enterobacter cloacae （16.19%） and Klebsiella pneumoniae （13.33%）;While Gram-positive bacteria are dominated by Staphylococcus aureus （1.90%）, coagulase-negative staphylococci （1.90%） and Enterococcus （1.90%）;Specimen collections accounting for the top threeare blood （22.85%）, lower respiratory tract specimens（18.09%）,and secretions（13.33%）;In Gram-negative bacteria, the most drug-resistant are Escherichia coli and Klebsiella pneumonia. Their susceptibility to carbapenems imipenem are 100%; gram-positive bacteria, Staphylococcus aureus’resistance rate to penicillin reaches 100%,but no vancomycin resistance is found,The same is true for Enterococcus. Conclusions：In hospital infection, gram-negative bacterial infection rate is higher. In these cases, some opportunistic pathogen detection rate increases, and high level of resistance to commonly used antimicrobial drug is discovered. Therefore, reducing the incidence of hospital infection and the number of pathogenic bacteria in hospital infection, paying attention to the culture of pathogenic bacteria, using antimicrobial agents rationally,and controlling hospital infection,has an important significance.