2263株院内感染常见病原菌分布及耐药性分析  

Clinical distribution and drug resistance analysis of 2263 strains of pathogens causing nosocomial infection

作　　者：翟如波[1] 张昊[1] 孙跃岭[1] 邱广斌[1] 

机构地区：[1]解放军第202医院检验科,沈阳市110003

出　　处：《中华实验和临床感染病杂志（电子版）》2012年第5期26-29,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的回顾性分析临床分离的引起院内感染的常见病原菌分布及对常用抗菌药物的耐药情况,为临床合理用药提供一定的依据。方法对本院2010年1月～12月临床送检的各类标本进行分离培养,采用VITEK-2 Compact全自动微生物仪进行菌株鉴定,采用K-B纸片扩散法检测对抗菌药物的敏感性,判定标准依据美国临床和实验室标准化研究所(CLSI)2009年的相关规定。结果本研究分离出病原菌共2263株,以革兰阴性杆菌为主,常见病原菌依次为大肠埃希菌、克雷伯菌属、铜绿假单胞、金黄色葡萄球菌和不动杆菌属。产ESBLs的大肠埃希菌和克雷伯菌属对抗菌药物的耐药率显著高于非产ESBLs的相应菌株,铜绿假单胞菌和不动杆菌出现多耐药及泛耐药菌株,对碳青霉烯类抗菌药物的耐药性也逐步升高,MRSA表现为多重耐药性和异质性,未发现万古霉素和利奈唑胺耐药菌。结论合理应用抗菌药物,切断病原菌传播途径,加强消毒隔离和对重症患者的监测,防止交叉感染,可减缓耐药菌的产生和传播。Objective To provide a basis for clinical use of drugs and clinical isolates of the distribution of common pathogens and resistance to commonly used antibiotics were analyzed, retrospectively. Methods Bacteria were isolated from various clinical specimens from January to December 2010, and identified by VITEK-2 Compact automatic analyzer. Antimicrobial susceptibility test was carried out by Kirby-Bauer method, and the results were assessed according to CLSI （version 2009） criteria. Results Total of 2263 nosocomial pathogens were collected, mainly gram-negative bacilli pathogens. The most common pathogens in sequence were Escherichia coli, Klebsiella, Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter. Escherichia coli and Klebsiella with ESBL were more resistant to antibiotics than those without ESBL. Pseudomonas aeruginosa and Acinetobacter were multi-drug resistant and were more resistant to carbapenems antibiotics. MRSA appeared multi-drug resistance and heterogeneity, however, no linezolid-resistant and vancomycin-resistant staphylococcus strain was noted. Conclusions By the means of rational usage of antimicrobial drugs, cutting off pathogen transmission routes, strengthening disinfection and isolation and monitoring of critically ill patients, cross-infection prevention, the antibiotics appearance and propagation could be slowed down.

关 键 词：医院感染 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]