呼吸科多药耐药菌感染患者病原菌分析与预防

Analysis and prevention of pathogens causing multi-resistant bacteria infections in respiratory department

目的探讨分析呼吸科多药耐药菌（MDROs）感染患者病原菌检测结果及预后与预防控制综合措施,为MDROs的预防控制提供参考。方法收集2012年6月-2014年5月39例MDROs感染患者临床资料,检测及分析细菌培养及药敏试验结果、预后。结果 39例患者检出病原菌主要为：产ESBLs大肠埃希菌、金黄色葡萄球菌、产ESBLs肺炎克雷白菌等,分别占33.33%、15.38%、12.82%;产ESBLs大肠埃希菌、产ESBLs肺炎克雷白菌、铜绿假单胞菌对头孢他啶、头孢曲松、氨苄西林等抗菌药物耐药率在20.00%-100.00%,金黄色葡萄球菌对青霉素G、氨苄西林、苯唑西林等抗菌药物耐药率在66.67%-100.00%,对万古霉素、喹奴普汀/达福普汀耐药率为0.00%;治疗后死亡1例,2例放弃治疗,36例患者病情稳定或痊愈出院。结论 MDROs感染病原菌主要以产ESBLs大肠埃希菌、金黄色葡萄球菌、产ESBLs肺炎克雷白菌、铜绿假单胞菌、鲍曼不动杆菌等多见,应多环节做好MDROs预防控制综合措施的实施,以防止呼吸科MDROs感染和扩散。

OBJECTIVE To study and analyze the detection results of pathogens in MDROs infected patients in the department of respiration and to discuss the prognosis and prevention and control measures so as to provide references for preventing and controlling MDROS.METHODS Totally 39 cases of MDROs infected patients were admitted and chosen as objects from Jun.2012 to May 2014.Their bacteria culture and drug sensitivity results were detected.RESULTS The main pathogens detected in the 39 cases were ESBLs-producing Escherichia coli,Staphylococcus aureus,and ESBLs-producing Klebsiella pneumoniae,accounting for 33.33%,15.38% and 12.82%,respectively.The drug resistance rates of ESBLs-producing K.pneumoniae and Pseudomonas aeruginosato ceftazidime,ceftriaxone,piperacillin were between 20.00%and 100%.The drug resistance rates of S.aureus to penicillin G,ampicillin and oxacillin were between 66.67%and 100%,while to vancomycin and quinupristin/dalfopristin were 0.00%.After treatment,except that 1case died and 2abandon treatment,36 cases became stable in the condition or recovered.CONCLUSIONThe main pathogens that cause MDROs infections include：ESBLs-producing E.coli,S.aureus,ESBLs-producing K.pneumonia,P.aeruginosa,Acinetobacter bauman,etc.Measures to prevent and control MDRO infections should be taken to prevent outbreak of the infection.