院内感染中多重耐药菌的临床分布及耐药分析  

Distribution and Drug Resistance Analysis of Multi-drug Resistant Bacteria in Nosocomial Infections

作　　者：韩东升[1] 韩崇旭[1] 薛小萍[1] 

机构地区：[1]江苏省苏北人民医院临床医学检测中心,江苏扬州225001

出　　处：《现代预防医学》2014年第22期4166-4168,共3页Modern Preventive Medicine

摘　　要：目的了解耐碳青霉烯鲍曼不动杆菌(CR-AB)和耐甲氧西林金黄色葡萄球菌(MRSA)在某院院内感染中的临床分布和耐药情况,指导临床合理选用抗菌药物。方法回顾性分析2011-2012年该院住院患者CR-AB和MRSA的感染情况,利用纸片扩散法对收集的菌株进行药敏试验。结果共检出CR-AB 60株,主要分布在ICU病房,占60.00%(36/60);MRSA 81株,主要分布在神经外科,占37.04%(30/81)。痰液是CR-AB和MRSA最主要的标本来源,分别占71.67%和56.79%。CR-AB对多数抗菌药物的耐药率均达到50.00%以上,但对米诺环素(26.67%)、丁胺卡那霉素(21.67%)、妥布霉素(16.67%)耐药率均低于30.00%,未发现耐多粘菌素的菌株;MRSA对利奈唑烷、万古霉素和替加环素100.00%敏感,对利福平、呋喃妥因和奎努普汀/达福普汀的耐药性较低(<30.00%)。结论CR-AB和MRSA的耐药性较为严重,应加强对重点感染科室的重点管理,根据药敏结果,合理选择抗菌药物,以控制CR-AB和MRSA等多重耐药菌株的传播。Objective The aim of this study was to investigate the distributions and the antimicrobial resistance of Carbapenem- resistant Acinetobacter baumannii （CR-AB） and methicillin-resistant Staphylococcus aureus （MRSA） in the Northern Jiangsu People＇s Hospital, to provide a scientific reference for the rational use of antimicrobial drugs. Methods All CR-AB and MRSA isolates from hospitalized patients from 2011 to 2012 were collected and retrospectively analyzed. K-B disk diffusion method was used for antimicrobial resistance test. Results A total of 60 CR-AB strains and 81 MRSA strains were isolated. CR-AB mainly distributed in the ICU, accounting for 60.00% （36/60）. MRSA were mainly isolated from Neurosurgery, accounting for about 37.04% （30/81）. 71.67% of CR-AB strains and 56.79% of MRSA strains were from Sputum specimens. The antimicrobial resistance rate of CR-AB to most antimicrobial drugs were 50% or above, but that to minocycline （26.67%）, amikacin （21.67%） and tobramycin （16.67%） were all less than 30.00%. No strains resistant to polymyxin was found. All MRSA strains were sensitive to linezolid, vancomycin, and tigecycline, and the resistance rates of them to rifampicin, nitrofurantoin and Kuinuputing/dalfopristin were low （less than 30.00%）. Conclusion The antimicrobial resistance of CR-AB and MRSA was serious. In order to effectively control the spread of CR-AB, MRSA and other multi-drug resistant bacteria, it is necessary for us to strengthen the management of key departments, and select antimicrobial drugs by drug susceptibility test results.

关 键 词：耐碳青霉烯鲍曼不动杆菌 耐甲氧西林金黄色葡萄球菌 院内感染 

分 类 号：R378[医药卫生—病原生物学]