2014～2017年我院微生物检验中的多重耐药情况分析

Analyze of the multi-drug resistance of the pathogenic bacteria during the microbiological test in our hospital in 2014-2017

目的分析2014~2017年我院微生物检验中的多重耐药情况。方法临床选择2014~2017年我院临床微生物送检标本12 306份,应用法国生物梅里埃VITE2-Compact药敏分析仪进行药敏试验和鉴定,评估我院2014~2017年微生物菌株及多重耐药菌情况。结果送检标本12 306份,病原菌检出2000份,病原菌阳性检出率为16.3%,其中检出病原菌前三位的送检标本分别为血液标本412份(26.9%)、分泌物标本280份(17.5%)、痰液标本304份(17.0%)。检出多重耐药菌分布的科室分别为呼吸内科136株(33.7%)、心胸外科120株(29.8%)、骨外科30株(7.4%)、肿瘤科43株(10.7%)、骨外科40株(9.9%)、烧伤科23株(5.7%)、消化内科11株(2.8%),共403株。本研究病原菌耐药预警情况分析显示,耐药最严重为革兰阴性菌的鲍曼不动杆菌,其次为阴沟肠杆菌、大肠埃希菌,而革兰阳性菌种耐药最多者为表皮葡萄球菌及金黄色葡萄球菌。结论我院2014~2017年多重耐药菌种最多的是革兰阴性菌,控制及预防医院感染、抗菌药物的合理应用是提高医疗质量、降低病原菌耐药性的有效措施。

Objective To analyze the multi-drug resistance of the pathogenic bacteria during the microbiological test in our hospital in 2014-2017.Methods A total of 12 306 specimen delivered from 2014 to 2017 in our hospital were selected.The Bio Mérieux VITE2-Compact drug sensitivity analyzer and the microbiological identification instrument were used to take the drug sensitivity test and identification.The multi-drug resistance of the microbiological strains taken in 2014-2017 were evaluated.Results For 12 306 specimen,there were 2000 samples of pathogenic bacteria;the positive detection rate of pathogenic bacteria was 16.3%of which the top three samples included 412 blood specimen(26.9%),280 secretion specimen(17.5%)and 304 sputum specimen(17.0%).There were 403 samples of multi-drug resistant pathogenic bacteria included 136 strains(33.7%)in the respiratory medicine department,120 strains(29.8%)in the cardio-thoracic surgery department,30 strains(7.4%)in the orthopedic surgery department,43 stains(10.7%)in the oncology department,40 strains(9.9%)in the orthopedic surgery department and 23 strains(5.7%)in the burns department and 11 strains(2.8%)in the gastroenterology department.According to the drug resistance analysis of the pathogenic bacteria,the Acinetobacter baumanmii of gram-negative bacteria had the highest drug resistance,followed by Enterobacter cloacae and Escherichia coli.The gram-positive bacteria of Staphylococcus epidermidis and Staphylococcus aureus had the highest drug resistance.Conclusion During the microbiological test in 2014-2017,the gram-negative bacteria have the highest multi-drug resistance.The control and prevention of the nosocomial infection and the reasonable application of the anti-bacterial agents are beneficial to improve the medical treatment quality and reduce the drug resistance of the pathogenic bacteria.