包头市6所三级甲等医院2015—2016年ICU多重耐药菌监测分析

Monitoring and analysis of multiple drug-resistant organisms in ICU from 2015 to2016 in six hospitals of Class Ⅲ Grade A in Baotou city

目的对包头市6所三级甲等医院2015—2016年度ICU患者多重耐药菌(MDROs)的检出率进行调查。方法选取2015年1月1日至2016年12月31日,在包头市6所三级甲等医院ICU病房入住患者的16303株菌株,利用VITEK-2Compact全自动微生物分析仪,进行细菌种类鉴定和药敏试验。结果 (1)2015年共分离了7625株,2016年共分离了8678株。(2)感染率最高的5种菌种分别为大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌和金黄色葡萄球菌。(3)MDROs检出率较高的MDROs分布包括产超广谱β-内酰胺酶细菌、耐甲氧西林金黄色葡萄球菌、多重耐药铜绿假单胞菌和多重耐药鲍曼不动杆菌,2015—2016年均未检出耐万古霉素金黄色葡萄球菌,未发现耐万古霉素菌株。(4)2016年MDROs检出率与2015年相比,差异无统计学意义(P>0.05)。2015年6所医院MDROs的检出率分布在20.29%~32.92%之间;2016年6所医院MDROs的检出率分布在21.22%~35.31%,年内分别比较,6所医院之间差异均无统计学意义(P>0.05)。结论我市6所三级甲等医院的MDROs菌株主要包括:产超广谱β-内酰胺酶细菌、耐甲氧西林金黄色葡萄球菌、多重耐药铜绿假单胞菌和多重耐鲍曼不动杆菌,2015—2016年MDROs的检出率保持稳定。

Objective To investigate the detection rate of multiple drug-resistant organisms(MDROs)of the patients in ICU from 2015 to 2016 in six hospitals of ClassⅢGrade A in Baotou city.Methods 16303 strains from patients in ICU from January 1,2015 to December 31,2016 were selected in six hospitals of ClassⅢGrade A in Baotou city.Bacterial species identification and susceptibility test were carried out by VITEK-2 compact automatic microbiological analyzer.Results(1)7625 strains in 2015 and 8678 strains in 2016 were isolated.(2)The five strains with the highest infection rate were Escherichia coli,Pseudomonas aeruginosa,Acinetobacter baumannii,Klebsiella pneumoniae and Staphylococcus aureus.(3)The high detection rate of MDROs included:the ultra-broad-spectrum enzyme bacterium(ESBLs),methicillin-resistant staphylococcus aureus(MRSA),multidrug resistant pseudomonas aeruginosa(MDRR-PA)and multi-drug-resistant acinetobacter baumannii(MDR-AB).No vancomycin-resistant staphylococcus aureus(VRSA)was detected and no vancomycin-resistant stains was found in 2015-2016.(4)The difference was no significant in the detection rate of MDROs in 2016 compared with 2015(P>0.05).The detection rate of MDROs in six hospitals was 20.29%~32.92%in 2015 and was 21.22%~35.31%in2016.There were all no significant differences among the six hospitals during one year(P>0.05).Conclusion MDROs in six hospitals of ClassⅢGrade A in Baotou city mainly include:ESBLs,MRSA,MDRR-PA,MDR-AB.The detection rate of MDROs remained stable from 2015 to 2016.