2011-2012年医院获得性感染病原菌分布与耐药性变迁  

Distribution and change of drug resistance of pathogens causing hospital-acquired infections from 2011 to 2012

作　　者：于良生[1] 宋金明[1] 纪恒胜[1] 

机构地区：[1]青岛大学附属医院药品调剂科,山东青岛266003

出　　处：《中华医院感染学杂志》2015年第17期3869-3871,共3页Chinese Journal of Nosocomiology

基　　金：山东省科技发展计划基金资助项目(2010GWZ20259)

摘　　要：目的探讨医院临床分离病原菌的分布特征及耐药变化,分析其耐药机制,为临床合理使用抗菌药物提供参考。方法回顾性分析医院2011年1月-2012年12月收治的14 827例患者临床资料,对其中发生感染患者的病原菌分布及其耐药性进行统计分析;使用世界卫生组织细菌耐药性监测网软件WHONET 5.6对数据进行统计分析。结果 14 827例患者中发生医院感染9 763例,感染率为65.85%;从12 798份感染标本中分离出病原菌11 519株,检出率为90.01%;其中革兰阴性菌7 128株占61.88%,革兰阳性菌3 716株占32.26%,真菌675株占5.86%;呼吸内科、ICU、神经内科、急症内科病原菌检出率较高;革兰阴性杆菌对亚胺培南和美罗培南100.00%敏感;革兰阳性菌对万古霉素、利奈唑胺100.00%敏感;耐甲氧西林金黄葡萄球菌、耐甲氧西林凝固酶阴性葡萄球菌对青霉素、头孢西丁100.00%耐药,而对万古霉素、利奈唑胺耐药率为0。结论医院感染以革兰阴性菌为主,耐药性严重,应加强对病原菌耐药性监测,合理选用抗菌药物,以防止病原菌耐药性的蔓延。OBJECTIVE To explore the distribution and drug resistance of the clinical isolates of pathogens and observe the drug resistance mechanisms so as to provide guidance for reasonable clinical use of antibiotics.METHODS The clinical data of 14 827 patients who were treated in the hospital from Jan 2011 to Dec 2012 were retrospectively analyzed,then the distribution and drug resistance of the pathogens causing the infections were statistically analyzed,and the statistical analysis of data was performed with the use of WHONET 5.6software.RESULTS The nosocomial infections occurred in 9 763 of 14 827 patients,with the infection rate of 65.85%.A total of 11 519 strains of pathogens were isolated from 12 798 infective specimens with the isolation rate of 90.01%,including7 128（61.88%）strains of gram-negative bacteria,3 716（32.26%）strains of gram-positive bacteria,and 675（5.86%）strains of fungi.The isolation rates of the pathogens were relatively high in the respiratory medicine department,ICU,neurology department,and emergency internal medicine department.The drug susceptibility rates of the gram-negative bacilli to imipenem and meropenem were 100.00%;the drug susceptibility rates of the grampositive bacteria to vancomycin and linezolid were 100.00%.The drug resistance rates of the methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococcus to penicillin and cefoxitin were100.00%,while the drug resistance rates to vancomycin and linezolid were 0.CONCLUSION The gram-negative bacteria are dominant among the pathogens causing the nosocomial infections and are highly drug-resistant.It is necessary to strengthen the surveillance of drug resistance of the pathogens and reasonably use antibiotics so as to prevent the spread of drug resistance of the pathogens.

关 键 词：医院获得性感染 病原菌 耐药性 药敏试验 

分 类 号：R378[医药卫生—病原生物学]