某妇幼保健院近3年多重耐药菌监测结果分析  

Surveillance and analysis of multidrug resistant bacteria in a maternal and child health hospital in recent three years

作　　者：马丽娜 白红艳[1] 李艳红[1] 史胜平[1] MA Lina;BAI Hongyan;LI Yanhong;SHI Shengping(Baoding Maternal and Child Health Hospital,Baoding,Hebei 071000,China)

机构地区：[1]保定市妇幼保健院,河北保定071000

出　　处：《医药前沿》2021年第36期1-3,共3页Journal of Frontiers of Medicine

摘　　要：目的:了解和分析保定市妇幼保健院对多重耐药菌(MDRO)的监测情况。方法:采用样本回顾性分析方法,对2017年1月—2019年12月保定市妇幼保健院MDRO监测进行分析。结果:29517份临床标本中有1272份培养阳性,检出率为4.31%,检出的1272菌株中,648株为MDRO菌株,占50.94%;MDRO主要为大肠杆菌、肺炎克雷伯菌、金黄色葡萄球菌、表皮葡萄球菌、人葡萄球菌、溶血性葡萄球菌和产酸克雷伯菌。标本种类较多,以痰液标本最常见,共检出435株,占67.13%,其次分别是血液标本15.74%(102/648)和脓液标本12.50%(81/648);检出的病原菌中,革兰氏阴性菌占74.69%(484/648),主要为大肠杆菌占51.08%(331/648)和肺炎克雷伯菌占22.99%(149/648);革兰氏阳性菌占25.31%(164/648),主要为金黄色葡萄球菌占13.12%(85/648)、表皮葡萄球菌占5.40%(35/648)和人葡萄球菌占5.25%(34/648)。3年大肠杆菌检出率(47.86%~53.53%)与肺炎克雷伯菌检出率(21.23%~23.74%)波动不大。在革兰氏阴性菌中,主要为大肠杆菌,对第一、二、三代头孢菌的耐药率超过75%;其次,是肺炎克雷伯菌对氨苄西林的耐药率也较高。结论:MDRO主要为革兰氏阴性菌,细菌耐药性严重。应根据细菌药敏试验的结果指导临床用药。主要预防控制措施是落实消毒和隔离,并加强对抗菌药物使用的管理。Objective To understand and analyze the monitoring of resistant organism(MDRO)in Baoding maternal and child health hospital.Methods The sample retrospective analysis method was used to analyze the MDRO monitoring of Baoding maternal and child health hospital from January 2017 to December 2019.Results 1272 of 29517 clinical specimens were positive.The detection rate was 4.31%,and 648 MDRO strains were detected,the detection rate was 50.94%;The main sources of MDRO are Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Staphylococcus epidermidis,human Staphylococcus,hemolytic Staphylococcus and acid producing Klebsiella.There were many kinds of specimens,and sputum specimens were the most common.A total of 435 strains were detected,accounting for 67.13%;The second were blood samples 15.74%(102/648)and pus samples 12.50%(81/648),respectively;Among the pathogens detected,Gram-negative bacteria were 74.69%(484/648),mainly Escherichia coli 51.08%(331/648)and Klebsiella pneumoniae 22.99%(149/648);Gram-positive bacteria were 25.31%(164/648),mainly Staphylococcus aureus 13.12%(85/648),Staphylococcus epidermidis 5.40%(35/648)and human Staphylococcus 5.25%(34/648).The detection rate of Escherichia coli in 3 years was 47.86%~53.53%;The detection rate of Klebsiella pneumoniae was also small(21.23%~23.74%).First of all,among Gram-negative bacteria,Escherichia coli is the main,and the drug resistance rate to the first,second and third generations of cephalosporins is more than 75%;Secondly,the resistance rate of Klebsiella pneumoniae to ampicillin was also high.Conclusion MDRO is mainly Gram-negative bacteria with serious drug resistance.Clinical medication should be guided according to the results of bacterial drug sensitivity test.The main preventive and control measures are to implement disinfection and isolation,and strengthen the management of the use of antibiotics.

关 键 词：妇幼保健院 多重耐药菌 耐药性 监测与分析 

分 类 号：R978.1[医药卫生—药品]