摘要
目的了解某三甲综合医院多重耐药菌株的科室分布及耐药性分析,以采取针对性的预防、控制和治疗措施。方法回顾性分析该院2014年1~12月检出的1 816株多重耐药菌数据。结果 1 816株多重耐药菌中以产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌居首位(665株,36.62%),然后依次为耐甲氧西林金黄色葡萄球菌(387株,21.31%)、耐碳青霉烯类抗菌药物的鲍曼不动杆菌(295株,16.22%)、多重耐药/泛耐药铜绿假单胞菌(195株,10.74%)、耐碳青霉烯类抗菌药物的肠杆菌科细菌(144株,7.92%)、产ESBLs的肺炎克雷伯菌(130株,7.16%)。分离到的多重耐药菌株主要集中在泌尿外科(384株,21.14%)、烧伤科(325株,17.90%)、重症监护室(ICU,266株,14.52%)、神经外科(110株,6.04%)。耐甲氧西林金黄色葡萄球菌对万古霉素和利奈唑胺的耐药率为0.0%;产ESBLs大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗菌药物的耐药率较低,小于2.9%;耐碳青霉烯类抗菌药物的肠杆菌科细菌对阿米卡星、复方磺胺甲噁唑、美洛培南和四环素的耐药率较低(39.6%~60.7%);耐碳青霉烯类抗菌药物的鲍曼不动杆菌对左旋氧氟沙星、四环素、复方磺胺甲噁唑和头孢哌酮/舒巴坦耐药率较低(48.9%~76.5%);多重耐药/泛耐药铜绿假单胞菌对阿米卡星、头孢他啶、庆大霉素和环丙沙星耐药率较低(45.3%~66.7%)。结论应加强对高危科室的监控,制定有针对性的预防控制措施,并根据药敏结果进行临床用药。
Objective To investigate the characteristics of department distribution and antibacterial resistance of multidrug‐re‐sistant(MDR) pathogens in hospital ,and take specific measures for the prevention ,treatment and infection cntrol .Methods Data of 1 816 MDR isolates detected in the hospital from January to December in 2014 were analyzed retrospectively .Results Among the 1 816 MDR strains ,extended‐spectrum β lactamases(ESBLs) producing Escherichia coli ranked first(665 strains ,36 .62% ) ,fol‐lowed by methicillin‐resistant Staphylococcus aureus(387 strains ,21 .31% ) ,MDR Acinetobacter baumannii(295 strains ,16 .22% ) , MDR Pseudomonas aeruginosa(195 strains ,10 .74% ) ,carbapenem‐resistant Enterobacteriaceae(144 strains ,7 .92% ) ,ESBLs pro‐ducing Klebsiella pneumoniae(130 strains ,7 .16% ) .MDR strains were mainly distributed in general department of urology surgery (384 strains ,21 .14% ) ,burn unit(325 strains ,17 .90% ) ,intensive care unit(ICU )(266 strains ,14 .52% ) and department neurosur‐gery(110 strains ,6 .04% ) .Vancomycin and linezolid resistance were not found in methicillin‐resistant Staphylococcus aureus ;less than 2 .9% of the ESBLs producing Escherichia coli and Klebsiella pneumonia strains were resistant to carbapenems .The resistance of carbapenem‐resistant Enterobacteriaceae to amikacin ,sulfamethoxazole‐trimethoprim ,meropenem and tetracycline were relatively low (39 .6% -60 .7% ) .The resistance of MDR Acinetobacter baumannii to levofloxacin ,tetracycline ,sulfamethoxazole‐trime‐thoprim and cefoperazone‐sulbactam were relatively low (48 .9% -76 .5% ) .The resistance of MDR Pseudomonas aeruginosa to amikacin ,ceftazidime ,gentamicin and ciprofloxacin were relatively low(45 .3% -66 .7% ) .Conclusion The MDR pathogens should be monitored in high‐risk department ,preventive measures should be taken ,and antibiotics should be used according to the results of drug susceptibility tests .
出处
《国际检验医学杂志》
CAS
2015年第20期2958-2960,共3页
International Journal of Laboratory Medicine
关键词
多重耐药菌
分布
耐药性
multidrug-resistant pathogens
distribution
resistance