医院感染病原菌监测及耐药性观察

目的监测我院医院感染病原菌分布及耐药状况,为指导临床合理用药及控制医院感染提供依据。方法采用全自动细菌鉴定及药敏分析仪,对本医院住院患者的各类标本分离细菌进行鉴定和耐药性分析。结果共分离出病原菌4978株,其中革兰阴性杆菌917株,革兰阳性球菌547株,其余为其他菌株。革兰阴性杆菌以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、阴沟肠杆菌为主,革兰阳性球菌以表皮葡萄球菌、粪肠球菌、金黄色葡萄球菌为主。大肠埃希菌、铜绿假单胞菌对头孢吡肟耐药率分别为48.6%和56.4%,其他革兰阴性杆菌对亚胺培南和美洛培南耐药率<6%。革兰阳性球菌对呋喃妥因和万古霉素均比较敏感,金黄色葡萄球菌对莫西沙星耐药率高达76%。结论医院感染病原菌以革兰阴性杆菌和革兰阳性球菌为主,这些致病菌对常用抗生素耐药率较高,必须加强耐药性监测和药敏试验,指导合理使用抗生素。

MONITORING OF PATHOGENS OF NOSOCOMIAL INFECTIONS AND OBSERVATION OF DRUG RESISTANCE

Objective To investigate distribution of pathogens of nosocomial infections and drug resistance in this hospital in order to provide basis for instructing clinical rational use of drugs and control of nosocomial infections. Methods Automatic bacteria identification and drug sensitivity analysis instrument was used to identify the bacteria isolated from various specimens taken from the patients of this hospital and to analyze the drug resistance.Results A total of 4978 strains of pathogens were isolated. Of them, 917 were Gram-negtive bacilli,547 of cram-positive cocci and the others. The most common pathogens of them were Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii and Enterobacter cloacae. The drug-resistance rates of Escherichia coli, and Pseudomonas aeruginosa to cefepime were 48.6% and 56.4% respectively. However,the drug resistance rates of other Gram-negative bacilli to imipenem and meropenam were lower than 6%. There were 547 strains of Gram-positive cocci which were relatively sensitive to nitrofurantoin and vancomycin. The drug-resistance rate of Staphylococcus aureus to moxifloxacin was as high as 76%. Conclusion Pathogens of nosocomial infections are mainly Gram-negative bacilli and Gram-positive cocci and they have high drug-resistance rate to common antibiotics, so it is mandatory to strengthen drug-resistance monitoring and drug sensitivity test in order to instruct rational use of antibiotics.