某三级综合医院多重耐药菌临床分布

目的了解某院多重耐药菌的临床分布特点，以采取针对性的预防控制措施。方法回顾性分析该院2012年1月1日-12月31日检出的891株多重耐药菌监测资料。结果 891株多重耐药菌中，以产超广谱β 内酰胺酶（ESBLs）的大肠埃希菌居首位（342株，38.39%），其次为产ESBLs肺炎克雷伯菌（195株，21.89%）、多重耐药鲍曼不动杆菌（185株，20.76%）、耐甲氧西林金黄色葡萄球菌（138株，15.49%）、多重耐药铜绿假单胞菌（27株，3.03%）、产ESBLs奇异变形杆菌（2株，0.22%）、产ESBLs产酸克雷伯菌（2株，0.22%）；主要集中在综合重症监护室（ICU；163株,18.29%）、神经内科（136株,15.26%）、普通外科（103株,11.56%）、神经外科（85株,9.54%）和呼吸内科（71株,7.97%）。痰标本分离多重耐药菌最多的是多重耐药鲍曼不动杆菌(242株，50.63%)，主要集中在综合ICU；尿标本分离最多的是产ESBLs大肠埃希菌(141株，80.57%)，主要集中在神经内科和泌尿外科。结论该院多重耐药菌感染部位主要为下呼吸道和泌尿系统；应加强对高危科室和易感人群的监控，制定有针对性的预防控制措施，遏制多重耐药菌的感染和传播。

Clinical distribution of multidrug resistant organisms in a comprehensive hospital

ObjectiveTo realize the characteristics of clinical distribution of multidrug resistant organisms (MDRO) in a hospital,and take specific measures for the prevention and control of infection.MethodsSurveillance data of 891 MDR isolates detected in a hospital between January 1 and December 31, 2012 were analyzed retrospectively.ResultsOf 891 MDR isolates, extended spectrum β lactamase(ESBL) producing Escherichia coli ranked first（342，38.39%）, followed by ESBL producing Klebsiella pneumoniae（195，21.89%）,MDR Acinetobacter baumannii（185，20.76%）, methicillin resistant Staphylococcus aureus（138，15.49%）, MDR Pseudomonas aeruginosa（27，3.03%）, ESBL producing Proteus mirabilis（2，0.22%）,and ESBL producing Klebsiella oxytoca（2，0.22%）; Bacteria mainly concentrated on general intensive care unit(ICU)(163,18.29%）, department of neurology（136,15.26%），general surgery(103,11.56%),neurosurgery（85,9.54%）, and respiratory diseases department（71,7.97%）.The most common bacteria isolated from sputum was MDR Acinetobacter baumannii (242，50.63%),and mainly concentrated on general ICU; the most common bacteria isolated from urine was ESBL producing Escherichia coli(141，80.57%), mainly concentrated on the departments of neurology and urology. ConclusionMDRO infection in this hospital mainly concentrate on lower respiratory tract and urinary system. Monitor on high risk departments and vulnerable patients should be intensified, targeted preventive measures should be stressed to curb MDRO infection and spread.