多重耐药菌医院感染情况的调查

Investigation of Nosocomial Infection Conditions of Multiple Resistant Bacteria

目的：分析医院感染多重耐药菌的种类及分布,为临床合理用药和控制医院感染提供依据。方法：采用美国BD公司phoenix-100型全自动细菌分析仪细菌鉴定,同时用Whonct5软件对分离到的多重耐药菌进行分析。结果：2014年1~6月份分离多重耐药菌共计955株,检出数量最多的为多重耐药鲍曼不动杆菌411株、占43.04%,其次为多重耐药铜绿假单胞菌289株、占30.26%,产碳青霉烯酶的肠杆菌科细菌（CRE）171株、占17.91%,耐甲氧西林金黄色葡萄球菌（MRSA）84株、占8.79%;主要分布的科室为ICU 484株、占50.68%,神经重症病房249株、占26.07%,神经外科108株、占11.31%。4种多重耐药菌主要分离自痰标本,依次为多重耐药鲍曼不动杆菌392株（41.05%）、多重耐药铜绿假单胞菌278株（29.11%）、产碳青霉烯酶的肠杆菌科细菌138株（14.45%）及耐甲氧西林金黄色葡萄球菌53株（5.55%）。结论：多重耐药菌主要来自医院呼吸道感染,提示应加强对高危科室及易感人群的监控,有效遏制多重耐药菌的感染和传播。

Objective： To provide the reference for rational use of the medicine and controlling nosocomial infection in clinic by analyzing the distribution and the sorts of multiple resistant bacteria（MDR）. Methods： The bacteria were identified by phoenix-100 type automatic bacteria analyzer from American BD Company, and MDR was analyzed by Whonct5 software at the same time. Results： All 955 strains of MDRs were separated from January to June of 2014, most of MDRs were baumanii and there were 411 strains detected, they occupied 43.04%; 289 strains of Pseudomonas aeruginosa（PA） were the next, and they held 30.26%; 171 strains of carbapenemase-resistant enterobacteriaceae（CRE） and 17.91%; 84 strains of methicillin-resistant staphylococcus aureus（MRSA） and 8.79%; 484 strains distributed in ICU mainly, and 50.68%; 249 strains in severe neurology department and 26.07%; 108 strains in neurosurgery department and 11.31%. Four kinds of MDRs were mainly separated from the sputum, they were392 strains of baumanii（41.05%）, 278 strains of PA（29.11%）, 138 strains of CRE（14.45%） and 53 strains of MRSA（5.55%）. Conclusion： MDR is mainly from hospital respiratory tract infection, which suggests that the monitoring of high risk department and vulnerable populations should be enhanced, the infection and spread of MDR could be effectively controlled.