2013-2015年医院感染病原菌的分布及耐药性分析

Distribution and drug resistance of pathogens causing nosocomial infections during 2013-2015

目的了解医院感染病原菌分布及其耐药性,为指导临床抗菌药物的合理使用提供依据。方法对2013年10月至2015年5月临床送检的各类标本中分离的病原菌及耐药性进行回顾性统计分析。结果共检测出病原菌2 032株,其中革兰阴性菌占72.7%,革兰阳性菌占21.6%,真菌占5.7%;大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌和鲍曼不动杆菌的检出率分别为14.5%、12.1%、11.3%和10.8%。多重耐药菌的检出率达13.1%,其中耐碳青霉烯类大肠埃希菌、铜绿假单胞菌和鲍曼不动杆菌的检出率分别为该菌种的0.4%、22.8%和71.8%。耐甲氧西林金黄色葡萄球菌的检出率为16.9%。还检测出1株耐万古霉素屎肠球菌。结论医院感染以革兰阴性杆菌为主,多重耐药菌的检出率较高。临床上应重视病原微生物的培养,加强多重耐药菌感染患者的管理及抗菌药物的合理使用,减少耐药菌株的产生。

AIM To investigate the distribution and drug resistance of pathogens causing nosocomial infections for reference of clinical rational use of antibacterial drugs. METHODS The pathogens isolated from the specimens sent for bacterial culture from October 2013 to May 2015 and their distribution and drug resistance were analyzed statistically. RESULTS A total of 2 032 pathogen strains were isolated, of which, gram-positive strains＇ rate was 72.7 %, gram-neg- ative strains＇ rate was 21.6%, fungal rate was 5.7%. The rate of Escherichia coli （EOC）, Pseudomonas aeruginosa （ PAE）. Klebsiella pneumonia （KPN） and Acinetobacter baumannii （ABA） was 14.5 %, 12.1%, 11.3 % and 10.8 %respectively. The drug resistance of EOC, PAE and ABA to carbapenems was 0.4%, 22.8% and 71.8% respectively, and the detection rate of multiple resistant bacteria （MDR） was 13.1%, methicillin resistant S. aureus （MRSA） was 16.9 %, and one vancomycin resistant to Enterococcus faecium （VRE） was detected, respectively. CONCLUSION Gram-negative bacilli took the lead in nosocomial infection, and the detection rate of MDR is higher. Thus it is important to pay attention to the bacterial culture, strengthen the management of patients with MDR infection, improve the rational use of antibacterial drugs, and reduce the generation of drug-resistant strains.