院内主要病原菌感染及其耐药性分析

目的调查院内感染的主要病原菌,探讨菌株对常用抗生素的耐药性问题,指导临床合理使用抗生素。方法应用WHONET5软件对本院微生物室2004年7月至2005年12月检出的3612例阳性标本的病原菌分布及其耐药性进行统计分析。结果院内感染仍以条件致病菌为主,革兰阴性菌检出率较高,占检出病原菌的56.3%,其中大肠埃希菌及克雷伯菌属的ESBLs阳性率分别为24.3%和50.8%;革兰阳性菌的检出占37.4%,其中金黄色葡萄球菌(MRSA)及凝固酶阴性葡萄球菌(MRSCN)的检出率分别为20.4%和67.8%;真菌检出率为6.3%。从标本种类分析,主要以下呼吸道、外科感染及泌尿系感染为主,大多数病原菌对多种抗生素产生耐药性。结论由于临床抗生素的广泛使用,病原菌不断变迁且其耐药性逐渐上升,我们应加强对病原菌的监测,为临床抗感染治疗提供可靠依据。

Analysis of The Major Bacteria and Its Drug-resistance in The Nosocomial Infection

Objective To investigate the major bacteria and its drug resistance in nosocomial infectious,and instructreasonable choices of antibiotics.Methods the bacterium's distribution and its drug-resistance of 3612 positive specimens during 2004.7-2005.12 were analyzed with WHONET5.3 software.Results the conditional pathogenic bacteria is the primary pathogenic bacteria of the nosocomial infection,the detection rates of bacteria with negative and positive Gram-staining is 56.3% and 37.4%,respectively,and 6.3% for fungi.According to the detection rate from high to low,the common clinical pathogenic bacteria were Escherichia.coli,staphylococcus coagulase negative,pseudomonas aeruginosa,Klebsiella pneumoniae,pseudomonas alcaligenes.the major sources of infections werelower respiratory tract,surgical infection and urinary system.Most of bacteria under investigation in this study showed multiple resistances to antibiotics.Conclusion Due to the unreasonable use of antibiotics and variation of bacteria,thedrug-resistance was rapidly increasing,We should reinforce the monitoring the pathogenic bacteria,and provide reliability evidence for anti-infective therapy.