医院感染多药耐药菌的临床分布及耐药性分析

Distribution and drug resistant of multidrug-resistant bacteria for nosocomial infections

目的分析医院感染多药耐药菌的流行分布及耐药性,为临床合理用药提供科学依据,提高预防感染水平。方法对2013年6月—2014年5月的临床标本进行病原菌分离,按照《全国临床检验操作规程》进行细菌培养与鉴定;采用CLSI推荐的K-B法进行药敏实验。结果共检出病原菌518株,其中多药耐药菌138株,多药耐药菌检出率为26.64%,多药耐药菌中革兰阴性菌占81.88%(113/138),主要为大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌,分别为36.96%、16.67%、8.70%;多药耐药菌中革兰阳性菌占18.12%(25/138),主要为金黄色葡萄球菌、肠球菌属,分别为6.52%、5.80%。结论医院分离的多耐药菌革兰阴性菌占主导地位,提示临床医师应根据病原菌耐药特点,合理选择抗菌药物;加强多药耐药菌的监管,预防和减少多药耐药菌的产生。

Objective To analyze the distribution and drug resistance of multidrug-resistant bacteria causing nosocomial infections so as to guide the reasonable use of antibiotics and raise the level of infection prevention. Methods The specimens of nosocomial infection were isolated routinely from June 2013 to May 2014, the bacteria culture and identification were carred out by refering to the national clinical laboratory procedures, and the drug susceptibility testing was performed by K-B method of CLSI.Results A total of 518 strains pathogenic bacteria were isolated, among which there were 138（26.64%）strains of multidrugresistant bacteria. The isolation rate of gram-negative of multidrug-resistant bacteria was 81.88%（113/138）,escherichia coli bacteria accounted for 36.96%, pseudomonas aeruginosa accounted for 16.67%, acinetobacter baumannii accounted for 8.70%. The isolation rate of gram-positive of multidrug-resistant bacteria was 18.12%（25/138）, staphylococcus aureus accounted for 6.52%, enterococcus genera accounted for 5.80%. Conclusion The gram-negative bacteria are main pathogens in the multidrug-resistant bacteria isolated, which indicates that the antibiotics should be used reasonably on the basis of the species of the pathogens isolated, drug resistance. It is necessary to strengthen the monitoring of multidrug-resistant bacteria so as to prevent the emergence of drug resistant strains.