医院感染的耐药菌分布特点与药物应用

Distribution Characteristics and Drug Application of Drug-resistant Bacteria in Nosocomial Infection

目的分析我院医院感染的耐药菌分布特点以及抗生素的应用情况。方法选择2017年7月~2018年7月我院住院治疗的多重耐药菌感染者的生物标本进行细菌检测和药敏试验,并对结果进行分析。结果检出多重耐药菌的为962株,检出率为14.70%(962/6542);多重耐药菌株感染的发生率为21.74%(962/4425);其中有478株(49.69%)为产超广谱β-内酰胺酶(ESBLs)大肠埃希菌;科室分布主要以普外科(186株,19.33%)最高;大肠埃希菌和肺炎克雷伯菌对于头孢西丁、头孢哌酮-舒巴坦、美罗培南、亚胺培南、哌拉西林-他唑巴坦和阿米卡星的耐药率较低;金黄色葡萄球菌对于替考拉林、阿米卡星、庆大霉素、万古霉素和利奈唑胺的耐药率均为0,对于左氧氟沙星和莫西沙星的耐药率较低。结论细菌耐药的形势严峻,临床应用时要首选敏感度较高的抗生素,以防细菌耐药进一步发生。医院要严格加强防控举措,切实避免医院感染的发生。

Objective To analyze the distribution characteristics of drug-resistant bacteria in hospital infections in our hospital and the application of antibiotics.Methods The biological samples of multi-drug resistant patients hospitalized in our hospital from July 2017 to July 2018 were selected for bacterial detection and drug susceptibility test,and the results were analyzed.Results The number of multi-drug resistant strains detected was962,the detection rate was 14.70%(962/6542);the incidence of multi-drug resistant strain infection was 21.74%(962/4425);among them,478(49.69%)were production of extended-spectrumβ-lactamase(ESBLs)Escherichia coli;departmental distribution is mainly highest in general surgery(186 strains,19.33%);Escherichia coli and Klebsiella pneumoniae for cefoxitin and cefoperazone-the resistance rates of sulbactam,meropenem,imipenem,piperacillin-tazobactam and amikacin are lower;Staphylococcus aureus for teicoplanin,amikacin,Qingda the resistance rates of mycin,vancomycin and linezolid were all 0,and the resistance rates to levofloxacin and moxifloxacin were lower.Conclusion The situation of bacterial resistance is severe,and antibiotics with higher sensitivity should be preferred for clinical application to prevent further bacterial resistance.The hospital must strictly strengthen prevention and control measures to avoid hospital infections.