医院内感染病原菌及其对抗生素的耐药状况

调查1988年3月～5月我院591例住院病例,发生96例次院内感染,总发病率16.2％。院内感染病原菌中,革蓝氏阴性杆菌占72.9％,革蓝氏阳性球菌占12.9％,念珠菌属占14.1％。院内感染病原菌的耐药性明显高于院外菌株。绿脓杆菌对庆大霉素和羧苄青霉素的耐药率分别为63.6％和54.5％。其它革蓝氏阴性杆菌院内株对常用抗生素如氨苄青霉素、羧苄青霉素、庆大霉素和妥布拉霉素的耐药率分别为82.5％、 67.5％、47.5％和45％。革蓝氏阳性球菌院内株的耐药性也很严重,表葡菌对多种半合成青霉素类、红霉素、复方新诺明甚至万古霉素的耐药率达60％以上。同时分离出耐甲氧西林金葡菌。

STUDY ON PATHOGENS AND RESISTANCE TO ANTIBIOTICS OF BACTERIA INVOLVED IN NOSOCOMIAL INFECTIONS

Prospectively studies among 591 patients admitted in 4 departments of our hospital 1st,March through 31st,May 1988 were carried out.We estimated that 16.2 of NI occurred among every 100 admissions. The rate of infections in the respiratory tract was highest in NI and followed by NI of urinary tract, biliary tract and surgical wound etc.72.9% of organisms involved in NI were Gram-negative bacilli (GNB), in decreasing order:Ps, aeruginosa, E. coli E.cloacae, Klebsiella spp, Acinetobacter spp, Proteus spp, etc. Gram-positive cocci were 12.9%, including S.aerus and S.epidemi-dis,Candida spp was 14.1%.The bacterial resistance of NI was more than community-acquired infections (CI).The frequency of resistance(FR) to gentamicin and carbenic-illin of Ps.aeruginosa in NI were up to 63.6 and 54.5%. FR of other GNB in NI to ampicillin, carbenicillin, gentamicin and tobramycin accounted for 82.5, 67.5, 47.5 and 45.0%.The ureidopenicillins, the third generation cephalosporins, ofloxacin and new aminoglycosides were susceptible to Ps. aeruginosa and GNB in NI.The FR of S.epidermidis in NI to 8 of semisynthetic penicillins, erythromycin, SXT and vanco-mycin were up to 60%. 5 strains of MRS A were identified in cocci involved in NI.Both incidence of NI and FR of bacteria in NI are increasing. It suggested that rational administration of antibiotics should be pay attention and epidemiological surveillance of NI should be done.