228株医院内感染病原菌的分布与耐药分析  

Analysis on Distribution and Drug Resistance of 228 Strains of Pathogenic Bacteria for Nosocomial Infection

作　　者：杨金霞[1] 张红岩[1] 张翠霞[1] 董玲[1] 

机构地区：[1]山东省滨州市人民医院感染管理科,滨州256610

出　　处：《中国医药导刊》2011年第4期687-689,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:了解医院内感染病原菌的分布及耐药情况,为指导临床用药及控制医院感染提供参考依据。方法:收集2008年1月～2009年6月我院确诊为医院内感染病人的各类送检标本中分离的病原菌,药敏试验采用琼脂纸片扩散法,试验数据分析采用WHONET5.4软件。结果:228株医院感染病原菌中,包括G^-杆菌156株,占68.4%,前5位是铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、阴沟肠杆菌;G^+球菌58株,占25.4%,前3位是金黄色葡萄球菌、溶血性葡萄球菌、表皮葡萄球菌;SA分离18株,其中MRSA占23.6%,CNS分离21株,其中MRCNS 70.9%。真菌18株,占7.9%。G^-菌对青霉素高度耐药,对二代头孢普遍产生较高耐药性,对三代头孢的耐药率也较高,对四代头孢效果较好,但大肠埃希菌与肺炎克雷伯菌的耐药率大于50%。对哌拉西林/他唑巴坦的敏感效果好,对碳青霉烯类敏感性高,但铜绿假单胞菌与鲍曼不动杆菌已超过30%。G^+菌未发现对万古霉素耐药株,对青霉素、红霉素、克林霉素高度耐药,对复方新诺明耐药性改高,对喹诺酮类敏感性较好,对呋喃妥因、利奈唑烷、糖肽类抗菌药物高度敏感。结论:革兰氏阴性杆菌耐药严重,应定期进行细菌耐药监测,对合理应用抗菌药物,积极有效控制医院感染有重要意义。Objective：To understand the distribution and drug resistance of nosocomial infection pathogenic bacteria for clinical treatment and control of nosocomial infection reference.Methods：Collected in January 2008-June 2009 hospital patients diagnosed with nosocomial infection were isolated from specimens of various types of pathogens,antimicrobial susceptibility tests using agar disk diffusion method,test data analysis software used WHONET5.4.Results：228 hospital pathogens,including the G- 156 strains of bacteria,accounting for 68.4%,top 5 is Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,Enterobacter cloacae;G ~coccus 58,accounting for 25.4%,the former three are Staphylococcus aureus,Staphylococcus haemolyticus,Staphylococcus epidermidis;SA isolated 18 strains,including MRSA accounted for 23.6%,CNS isolated 21 strains,which accounted for 70.9% MRCNS. 18 strains of fungi,accounting for 7.9%.G- bacteria highly resistant to penicillin,against second-generation cephalosporins generally produce higher levels of drug resistance,resistance to third generation cephalosporins have a higher rate is better on the fourth generation eephalosporins,but Escherichia coil and Klebsiella pneumoniae resistance rates greater than 50%.Piperacillin/tazobactam-sensitive effect,on the carbapenem sensitive,but Pseudomonas aeruginosa and Acinetobacter baumannii have been more than 30%. G＊ bacteria was found in vancomycin-resistant strains to penicillin,erythromycin,clindamy cin high resistance,high resistance against cotrimoxazole,better sensitivity to quinolones,nitrofurantoin,linezolid alkyl,glycopeptide antibiotics highly sensitive.Conclusion：Serious Gram-negative bacilli resistant,antimicrobial resistance monitoring should be conducted regularly, on the rational use of antimicrobial agents,active and effective control of nosocomial infections is important.

关 键 词：医院感染 病原菌 抗菌药物 耐药监测 合理用药 

分 类 号：R446.5[医药卫生—诊断学]