医院感染多药耐药菌的临床分布与耐药性分析  

Distribution and antibiotic resistance of multidrug-resistant bacteria for hospital infections

作　　者：温婵[1] 耿蓉娜[1] 孙立新[1] 冀迎春[2] 赵博[3] 

机构地区：[1]河北省儿童医院医院感染管理处,河北石家庄050031 [2]河北省儿童医院医院科教处,河北石家庄050031 [3]河北医科大学实验诊断教研室,河北石家庄050031

出　　处：《中华医院感染学杂志》2015年第4期764-766,共3页Chinese Journal of Nosocomiology

基　　金：河北省科技厅计划基金资助项目(132777142)

摘　　要：目的了解医院感染多药耐药菌(MDRs)临床分布特点及耐药性,为临床合理使用抗菌药物提供依据。方法收集儿童专科医院2012年1-12月住院患儿送检的标本,经全自动微生物分析仪进行病原菌鉴定及药物敏感试验,采用统计方法分析其标本来源、科室分布以及其对常用抗菌药物的耐药性。结果全年共检出MDRs230株,分布较多的科室为新生儿科、普外科,分别占29.1%、28.2%,其次为重症科占17.8%,MDRAB、MDRPA主要来源于痰液,分别占89.3%、77.2%,MRSA主要标本来源于脓液占34.8%;MDRAB对氨苄西林、头孢曲松、阿莫西林/克拉维酸耐药率均为100.0%,MDRPA对阿莫西林/克拉维酸、亚胺培南、磺胺甲噁唑/甲氧苄啶耐药率均为100.0%,MRSA对青霉素类抗菌药物100.0%耐药,对万古霉素耐药率为0。结论 MDRs主要分布在新生儿科、普外科、重症科,儿科医师在应用抗菌药物之前开展病原菌耐药性监测,不能及时送检患儿标本时应根据相关报道合理使用抗菌药物,可减少或延缓耐药菌株的播散。OBJECTIVE To investigate the clinical distribution and antibiotic resistance of multidrug-resistant bacteria in Hebei Children′s Hospital in 2012 and provide an effective basis for reasonable use of antibiotics.METHODS Specimens of multidrug-resistant bacteria from children hospitalized from Jan.to Sep.2012 were collected.The species for bacteria and drug sensitivity test were identified by the automatic analyzer.The specimen sources,distribution in departments and drug resistance to commonly used antibiotics were statistically analyzed.RESULTS Totally 230 strains of MDRs were detected in the whole year and mainly distributed in the departments of neonatology（47.3%）and general surgery（28.2%）,followed by the intensive care unit（17.8%）.MDRAB and MDRPA were mainly isolated from sputum,accounting for 89.3% and 77.2%.MRSA samples were mainly from pus,accounting for 34.8%.MDRAB had 100.0%resistance to ampicillin,ceftriaxone,and amoxicillin/clavulanic acid.MDRPA had 100.0% resistance to amoxicillin/clavulanic acid,imipenem,and sulfamethoxazole/trimethoprim.MRSA had 100.0% resistance to penicillins and 0resistance to vancomycin.CONCLUSION MDRs were mainly distributed in the departments of neonatology,general surgery,and intensive care unit.Before application of antibiotics,pediatricians should carry out surveillance of antimicrobial resistance.When it is not possible to take pathogenic detection timely,pediatricians should rationally use antibiotics according to relevant study reports so as to reduce or postpone the spread of the drug resistant strains.

关 键 词：患儿 多药耐药菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]