新疆某医院多重耐药菌及耐药性分析

Distribution and antimicrobial resistance of multi-drug resistance organism in Xinjiang

目的回顾性分析2015年新疆医院临床分离多重耐药菌(multidrug-resistant organism,MDRO)的分布、类型及耐药性,为临床控制MDRO医院感染提供有效依据,为临床合理选用抗生素提供参考依据。方法 2015年1月至2015年11月期间对我院住院患者标本培养的多重耐药菌株,对其耐药菌类型与耐药性进行分析,并对高危因素进行分析与探讨。结果共检出、共分离出4560株细菌,其中多重耐药菌1210株。鲍曼不动杆菌344株,占28.40%,大肠埃希菌288株,占23.80%,铜绿假单胞菌201株,占16.60%,肺炎克雷伯菌150株,占12.40%,金黄色葡萄球菌100株,占8.30%,耐药性:鲍曼不动杆菌对碳青霉烯类抗生素耐药性为62.30%,多耐药肠杆菌科细菌对碳青霉烯类抗生素保持高度的敏感性(100%敏感),革兰氏阳性细菌主要为金黄色葡萄球菌,耐甲氧西林的金黄色葡萄球菌(MRSA)占65%,只对万古霉素敏感,未发现耐万古霉素、耐利奈唑胺菌株。结论该院分离的多重耐药菌种类多,耐药性严重,临床医师应重视病原学检查,并严格按照药物敏感试验结果选取合理抗生素,以减少细菌耐药性的发生,降低医疗费用,降低临床病死率。

Objective To retrospectively study on the distribution of clinical isolates multidrug-resistant organism（ MDRO） and drug resistance in 2015 in order to provide an effective basis for clinical control of MDRO in nosocomial infection. Methods The results of MDRD identification and drug sensitive test from Feb,2015 to Nov,2015 were analyzed retrospectively. Results A total of 4560 strains were isolated. There were 1210 strains of MDRO in the 4560 isolates,including 28. 4% of Acinetobacter baumannii（ n = 344）,23. 8% of Escherichia coli（ n = 288）,16. 6% of Pseudomonas aeruqinosa（ n = 201）,12. 4% of Klebsiella pneumonia（ n = 150）,and 8. 3%of Staphylococcus aureus（ n = 100）. The resistance of Acinetobacter baumannii to carbapenemases was 62. 30%,and Escherichia coli resistant to carbapenemases showed 100% sensitivity. Gram-positive bacteria mostly was Staphylococcus aureus,and Methicillin-resistant strains（ MRSA） were 65%,only sensitive to vancomycin. Linezolid and vancomycin-resistant strains were not detected. Conclusion Bacterial multiple antibiotic resistance in clinical strains is very popular,and clinical doctors should emphasize microbiological culture and use drugs rationally based on antimicrobial susceptibility results,in order to avoid the production and spread of drug resistant strains,reduce the medical expenses and clinical case fatality rate.