基层医院病原菌的分布及感染控制  

Pathogen Distribution and Infection Control in Grass Roots Hospitals

作　　者：杨萍[1] 徐逸鸣 冯芳[1] 田祎 欧阳霞[1] 

机构地区：[1]天门市第一人民医院医院感染管理科,湖北天门431700 [2]天门市卫生局医政科,湖北天门431700

出　　处：《中华医院感染学杂志》2010年第21期3412-3413,共2页Chinese Journal of Nosocomiology

摘　　要：目的了解医院临床送检标本中病原菌的分布及70所医疗机构抗菌药物使用情况,制定控制感染对策。方法对2005-2009年临床标本分离菌进行调查统计分析;对70所专科医院、卫生院、诊所等医疗机构抗菌药物使用情况进行调查。结果 2005-2009年收集标本31 908份,分离出病原菌4972株,分离率为15.58%;革兰阳性球菌感染比例逐年下降,分别为51.8%、44.3%、34.6%、21.4%、15.9%;革兰阴性杆菌感染比例逐年增加,分别为42.2%、49.2%、58.6%、65.7%、68.7%;真菌感染逐年增加,分别为6.0%、6.5%、6.8%、12.9%、15.4%;产超广谱β-内酰胺酶的革兰阴性杆菌比例逐年增加,分别为21.0%、42.0%、55.0%、33.0%、35.0%,致使头孢类药物的耐药率增加。结论加强基层医院抗菌药物使用的规范管理,提高病原学送检率按药敏试验报告选择药物,能有效控制医院感染。OBJECTIVE To investigate the pathogen distribution in hospital and the use of antibiotics in 70 medical institutions, in order to make infection control measures. METHODS The bacterial culture of specimens isolated from 2005 to 2009 were analyzed and the application of antibiotics in 70 medical institutions was investigated. RESULTS Totally 4972 pathogenic strains were isolated from 31 908 samples. G＋ cocci infections were decreased and G- bacilli and fungal infections were increased year by year. From 2005 to 2009, G＋ cocci infection rates were 51.8G, 44.3G, 34. 6G, 21. 4% and 15. 9%, respectively; G- bacilli infection rates were 42. 2%, 49. 2%, 58.6%, 65.78% and 68.7%, respectively, and the fungal infection rates were 6.0%, 6.5%, 6.8%, 12.9% and 15.4%, respectively＂ The detection rates of extended spectrum β-lactamase （ESBLS）-producing G bacilli were 21. 0%, 42. 0%, 55. 0%, 33. 0% and 35. 0% , respectively and the drug resistant rate to cephalosporins increased. CONCLUSION The change in pathogenic proportion shows that strengthening the standardized management of antibiotics, improving pathogen detection rate and choosing antibiotics on the basis of drug sensitivity test can effectively control the infection in grass roots hospitals.

关 键 词：基层医院 病原菌 感染控制 

分 类 号：R378[医药卫生—病原生物学]