2012-2016年某院新生儿科多重耐药菌的分布与变迁

Distribution and changes of multi-drug resistant organisms in Department of Neonatology of a hospital from 2012 to 2016

目的探讨多重耐药菌(MDRO)分布与变迁,为临床采取MDRO防控措施提供科学依据。方法回顾性分析某三甲妇女儿童专科医院新生儿科2012-2016年MDRO目标性监测结果,通过病历信息系统回查相关资料,对MDRO分布及变迁等情况进行分析与描述。结果共纳入本研究的MDRO 188株,分离自痰液、血液、气管导管残端、胃液、大便等。革兰阴性杆菌97株(51.60%),以产超广谱β-内酰胺酶(ESBL)菌为主;革兰阳性菌91株(48.40%),以耐甲氧西林凝固酶阴性葡萄球菌为主。肺炎克雷伯菌、表皮葡萄球菌、溶血性葡萄球菌检出情况总体呈下降趋势。社区获得感染与定植117株(62.23%),其中大肠埃希菌、肺炎克雷伯菌、表皮葡萄球菌呈下降趋势;医院获得感染与定植71株(37.77%),其中肺炎克雷伯菌、溶血性葡萄球菌及表皮葡萄球菌呈下降趋势,大肠埃希菌有上升趋势。MDRO的季度分布,除2012年以二季度较高外,其余均以三季度为高峰。结论新生儿科检出的MDRO以产超广谱β-内酰胺酶(ESBL)菌及耐甲氧西林凝固酶阴性葡萄球菌为主;院内获得的大肠埃希菌感染与定植有上升趋势;三季度可能为多重耐药菌检出的高峰。

Objective To explore the distribution and changes of multi-drug resistant organisms （MDRO）,provide a scientific evidence for taking prevention and control measures of MDRO.Methods The targeted monitoring results of MDRO in Department of Neonatology of a first-class hospital at grade 3 from 2012 to 2016 were retrospectively analyzed.The distribution and changes of MDRO were analyzed and depicted through medical record information system.Results There were 188 MDRO strains isolated from sputum,blood,stump of tracheal catheter,gastric juice,and stool.There were 97 strains of Gram-negative bacilli,accounting for 51.60%,extended-spectrum β-1actamase producing strains （ESBL） was the main type.There were 91 strains of Gram-positive bacteria,accounting for 48.40%,methicillin-resistant coagulase-negative Staphylococci was the main type.The detection rates of Klebsiella pneumoniae,Staphylococcus epidermidis,and Staphylococcus haemolyticus showed a general trend of decline.There were 117 strains of community-acquired infection and colonization,accounting for 62.23 %,the detection rates of Escherichia coli,Klebsiella pneumoniae,Staphylococcus epidermidis showed a decreasing trend.There were 71 strains of hospital-acquired infection and colonization,accounting for 37.77%,the detection rates of Klebsiella pneumonia,Staphylococcus haemolyticus,Staphylococcus epidermidis showed a decreasing trend,the detection rate of Escherichia coli showed an increasing trend.The detection rate of MDRO was the highest in the third quarter except for the second quarter in 2012.Conclusion The detection types of MDRO in Department of Neonatology are mainly ESBL and methicillin-resistant coagulase-negative Staphylococci.There is an uptrend in hospital-acquired infection and colonization of Escherichia coli.The third quarter has the peak detection rate for MDRO.