2010年多重耐药菌医院感染的分布及耐药性监测(1)
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[摘要] 目的 回顾性分析2010年我院临床分离多重耐药菌(multidrug-resistant organism，MDRO)的分布及耐药性，为临床控制MDRO医院感染提供有效依据。 方法 采用全自动微生物分析仪VITEK-2进行细菌鉴定，K-B纸片扩散法进行药敏试验。采用WHONTE 5.4软件分析分离菌的分布、分离率及药敏结果。 结果 3 737株分离菌中有2 255株为MDRO(60.3%)，主要多重耐药菌为耐甲氧西林的金黄色葡萄球菌(MRSA)和凝固酶阴性的葡萄球菌(MRCNS)、产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌(E.coli)和克雷伯菌(KNP)以及碳青霉烯耐药不动杆菌(CRABA)和铜绿假单胞菌(CRPAE)。革兰阳性MDRO仅对万古霉素和米诺环素比较敏感，MRSA对抗生素的耐药性较MRCNS更加严重，两者对环丙沙星、庆大霉素、克林霉素、米诺环素和左旋氧氟沙星的耐药率比较，差异有统计学意义(P < 0.05)，革兰阴性肠杆菌科细菌对亚胺培南、阿米卡星、头孢西丁和β-内酰胺/β-内酰胺酶抑制剂类抗生素敏感，革兰阴性非发酵菌对多黏菌素和头孢哌酮-舒巴坦较感。 结论 细菌的多重耐药性在临床分离菌株中非常普遍，对临床抗感染治疗构成了严重的威胁。合理选用抗菌药，及早检测MDRO，加强院内感染监测和采取有效的感染控制措施是控制感染播散的可行方法。
[关键词] 多重耐药菌；医院感染；耐药性监测；标本分布
[中图分类号] R378 [文献标识码] A [文章编号] 1673-7210(2012)02(c)-0084-04
Multidrug-resistant bacteria distribution and drug resistance monitoring of hospital infection in 2010
ZHANG Zhaoyong LI Xiandong WU Junzhu ZHANG Zhen YANG Hongwei
Department of Clinical Laboratory, Taihe Hospital Affiliated to Hubei Medical University, Hubei Province, Shiyan 442000, China
[Abstract] Objective To retrospectively study on the distribution of clinical isolates multidrug-resistant organism (MDRO) and drug resistance in 2010, in order to provide an effective basis for clinical control of MDRO in nosocomial infection. Methods Identification of bacteria was performed by automated microbe analyzer (VITEK-2) and antibiotic sensitivity test adopted Kirby-Bauer method. Date of isolation rate, drug resistant and sample distribution of bacteria were analyzed by WHONET 5.4 software. Results There were 2 255 strains were MDRO in the 3 737 isolates (60.3%), the main multi-drug resistant bacteria were Methicillin resistant strains in S.aureus (MRSA) and Coagulase negative staphylococcus (MRCNS), Production extra-broad spectrum beta-lactamase Escherichia coli and Klebsiella pneumoniae carbapenemase resistance Acinetobacter baumannii and pseudomonas aeruginaosa. Gram-positive. MDRO were sensitive to vancomycin and minocycline, Gram negative Enterobacteriaceae bacteria have high sensitive to imipenem, Amikacin, cefoxitin and beta-lactam/beta-lactamase inhibitor class of antibiotic, Gram-negative non-fermentative bacteria were sensitive only to colistin and cefoperazone/sulbactam ......
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