基于细菌耐药监测预警系统的多重耐药菌分析  

Analysis on multi-drug resistant bacteria based on bacterial drug resistance monitoring system

作　　者：黄学忠[1] 林佩佩[1] 谢雪蓓 

机构地区：[1]中国人民解放军第一一八医院,浙江温州325000

出　　处：《检验医学与临床》2015年第18期2666-2668,共3页Laboratory Medicine and Clinic

基　　金：南京军区医药卫生科研基金面上项目(11M4032)

摘　　要：目的分析近年来该院多重耐药菌监测情况,为医院多重耐药菌感染预防与控制提供客观依据。方法在以LIS-Excel为开发平台而创建的《细菌耐药监测预警系统》中,对2013年7月至2014年6月该院住院患者送检的1 815份标本中分离的阳性菌进行多重耐药菌分析,用U检验分析判断不同菌株多重耐药机制的差异显著性。结果在送检的1 815份标本中,共检出阳性菌822株,其中多重耐药菌209株,分别为铜绿假单胞菌39.71%、鲍曼不动杆菌30.62%,产超广谱β-内酰胺酶革兰阴性肠杆菌17.70%、耐甲氧西林金黄色葡萄球菌(MRSA)11.96%。多重耐药菌在各阳性菌株中的检出比率依次为鲍曼不动杆菌84.21%、金黄色葡萄球菌69.44%、铜绿假单胞菌60.58%、大肠埃希菌48.05%。在铜绿假单胞菌中,以耐碳青霉烯类抗菌药物为主,占73.49%,而鲍曼不动杆菌则以泛耐药株为主,占67.19%。结论该院近年来检出的多重耐药菌以革兰阴性菌为主,铜绿假单胞菌和鲍曼不动杆菌的耐药机制截然不同,前者以耐碳青霉烯类铜绿假单胞菌(CR-PA)为主,而后者则以泛耐药鲍曼不动杆菌(PDR-AB)为主。MRSA检出率虽仅11.96%,但近年来呈现回升态势,应引起临床关注。Objective To analyze the multi‐drug resistant bacteria monitoring situation in our hospital in recent years to provide the objective basis for the prevention and control of multi‐drug resistant bacteria .Methods 822 strains of positive bacteria isolated from 1 815 inpatients′ specimens from July 2013 to June 2014 were performed the multiple‐drug resistance bacterial analysis in the bacterial drug resistance monitoring system created in the LIS‐Excel development platform .The difference significance of multi‐drug resistance mechanism among different strains was analyzed by the U test .Results In 1 815 detected specimens ,822 strains of positive bacteria were detected ,in which 209 strains were multi‐drug resistant bacteria ,Pseudomonas aeruginosa accounting for 39 .71% ,Acinetobacter baumanii for 30 .62% and extended spectrum beta‐lactamases producing gram‐negative enteric bacilli for 17 .70% and methicilin‐resistant staphylococcus aureus for 11 .96% ,respectively .In the different positive strains ,the detection rate of multi‐drug resistant bacteria were in turn acinetobacter baumanii（84 .21% ） ,staphylococcus aureus（69 .44% ） ,Pseudomonas aeruginosa（60 .58% ） and E .coli（48 .05% ） ,respectively .In Pseudomonas aeruginosa ,carbapenem resistant antimicrobial drugs were predominant ,accounting for 73 .49% ,while Acinetobacter baumanii was mainly pandrug resistant strains ,accounting for 67 .19% .Conclusion The detected multi‐drug resistant bacteria in recent years are mainly gram‐negative bacteria .The drug‐resistance mechanism of pseudomonas aeruginosa and Acinetobacter baumanii is entirely different .Pseudomonas aeruginosa is given priority to CR‐PA and Acinetobacter baumanii is given priority to PDR‐AB .Although detected MRSA accounts for only 11 .96% ,but which shows the rebound trend in recent years and should arouse clinical attention .

关 键 词：细菌 耐药 多重耐药菌 监控 

分 类 号：R473.5[医药卫生—护理学]