2016年~2018年某中医医院多重耐药菌的回顾性分析

Retrospective Analysis of Multi-drug Resistant Bacteria in A Traditional Chinese Medicine Hospital from 2016 to 2018 Year

目的回顾分析2016年~2018年上海市青浦中医医院分离的多重耐药病原菌的感染率和临床分布情况,指导临床抗菌药物应用,并为医院院感科及药事委员会制定合适的措施和方案提供依据。方法分离培养上海市青浦中医医院2016年~2018年送检的各类标本,经法国生物梅里埃VITEK-2 COMPACT60全自动细菌鉴定及药敏分析仪进行细菌鉴定分析,对检出的病原菌及前5种多重耐药菌进行数据统计分析。结果2016年~2018年阳性病原菌检测总数总体呈上升趋势,前5位多重耐药病原菌分别为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌。主要感染人群为女性中老年患者,分布于泌尿科。结论医院药事委员会成立临床处方点评机制和检验科出具的微生物药敏报告,以及加强多重耐药菌医院感染监测和管理,可有效预防多重耐药的产生。

Objective Retrospectively analyze the infection rate and clinical distribution of multi-drug resistant pathogens isolated from Shanghai Qingpu Traditional Chinese Medicine Hospital from 2016 to 2018,guide clinical antimicrobial application,and provide a basis for the hospital to develop appropriate measures and programs.Methods Separate and cultivate all kinds of specimens sent to Shanghai Qingpu Traditional Chinese Medicine Hospital from 2016 to 2018,and carry out bacterial identification and analysis by the French biological Merrier VITEK-2 COMPACT60 automatic bacterial identification and drug sensitivity analyzer Statistical analysis of a variety of multi-drug resistant bacteria.Results From 2016 to 2018,the total number of positive pathogen detections showed an overall upward trend.The top 5 multi-drug resistant pathogens were Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus.The main infected population is female middle-aged and elderly patients,distributed in urology.Conclusion The establishment of a clinical prescription review mechanism and a microbial susceptibility report issued by the laboratory department of the Hospital Pharmacy Committee,as well as strengthening the monitoring and management of nosocomial infections of multi-drug resistant bacteria,can effectively prevent the emergence of multi-drug resistance.