某三甲医院2014年-2016年主要病原菌耐药趋势分析与预防控制研究  

Trend analysis and prevention and control of main pathogen resistance in a three-A hospital in 2014-2016

作　　者：韩颖[1] 王雅妹[1] 张新颖[1] 张晋[1] 李小雷[1] 周新玲[1] 

机构地区：[1]河北大学附属医院感染控制办公室,河北保定071000

出　　处：《中华医院感染学杂志》2017年第15期3419-3422,共4页Chinese Journal of Nosocomiology

摘　　要：目的了解某三甲医院感染主要病原菌检出及分布情况,以及病原菌的耐药性趋势变化,为临床合理选用抗菌药物提供依据,进一步规范抗菌药物的合理使用。方法收集2014年1月-2016年12月某三甲医院所有送检标本中分离出的2 122株病原菌,使用美国BD Phoenix 100全自动细菌鉴定分析仪对病原菌标本进行细菌鉴定,采用纸片扩散法进行药敏试验,使用SPSS 22.0软件分析其耐药性变化趋势。结果 3年共检出病原菌2 122株,检出主要病原菌为大肠埃希菌占33.45%、鲍氏不动杆菌占26.94%、铜绿假单细胞菌占22.39%、金黄色葡萄球菌占8.48%、肺炎克雷伯菌占8.74%;其中大肠埃希菌对头孢类抗菌药物耐药率较高,对碳青霉烯类抗菌药物耐药率较低;金黄色葡萄球菌对万古霉素耐药率较低;鲍氏不动杆菌对抗菌药物表现为普遍耐药;细菌耐药形势仍然严峻。结论某三甲医院主要病原菌耐药率总体维持在较高水平,需要进一步加强对细菌耐药性监测,指导临床合理选用抗菌药物,加强管理,提高医务人员的合理用药意识,规范用药和临床治疗过程。OBJECTIVE To understand main pathogens detection and distribution of nosocomial infections in a threeA hospital,as well as the main trend of the drug resistance of pathogenic bacteria,so as to provide basis for clinical rational use of antimicrobial drugs,further standardize the rational use of antibacterial drugs.METHODS A total of 2122 strains of pathogenic bacteria isolated from all samples submitted for examination at a three-A hospital from Jan.2014 to Dec.2016 were collected.The BD PhoenixTM 100 automatic bacteria identification analyzer was used for bacterial identification,and the disc diffusion method was used for drug sensitive test.SPSS22.0 software was used for the trend of drug resistance.RESULTS A total of 2122 pathogens were detected in 3 years.The main pathogens were Escherichia coli,Acinetobacter baumannii,Pseudomonas aeruginosa,Staphylococcus aureus,and Klebsiella pneumoniae,accounting for 33.45% ,26.94% ,22.39% ,8.48% ,and 8.74% ,respectively.The resistant rate of E.coli to cephalosporins was high,and to carbapenems was low.The resistant rate of S.aureus to vancomycin was low.A.baumannii was generally resistant to antibiotics.The situation of bacterial resistance was still grim.CONCLUSION The drug resistant rates of main pathogens in a three-A hospital is maintained at a high level,so it is necessary to strengthen the monitoring of bacterial resistance,guide the rational use of antibiotics in clinic,strengthen the management,improve the awareness of rational use of drugs among medical staff,and standardize the use of drugs and clinical treatment process.

关 键 词：病原菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]