某院2012年多重耐药菌分布及耐药性

目的调查某院2012年多重耐药菌（MDROs）的临床分布及耐药性，为防控MDROs感染提供理论依据。方法采用目标性监测方法对该院2012年1-12月检出的MDROs的分布及药敏结果进行分析。结果共检出MDROs 370株，其中革兰阴性(G-)杆菌341株（92.16%），革兰阳性(G+)球菌29株［7.84%，均为耐甲氧西林金黄色葡萄球菌（MRSA）］；临床分离MDROs前5位的科室分别为重症监护室（79株）、神经外科（65株）、神经内科（40株）、普通外科（39株）、老年科（32株）。29株MRSA对复方磺胺甲口恶唑、替加环素、利福平等抗生素耐药率均＞60%，无万古霉素耐药株；产超广谱β 内酰胺酶的大肠埃希菌和肺炎克雷伯菌对亚胺培南的敏感率＞75%，对头孢哌酮/舒巴坦、阿米卡星的敏感率在50%左右；多重耐药的铜绿假单胞菌和鲍曼不动杆菌对抗菌药物普遍不敏感，特别是多重耐药的鲍曼不动杆菌，几乎是泛耐药。结论该院分离的MDROs以G-菌为主，主要分离自收治重症及高龄患者的科室。需加强医院感染监测和采取有效的感染控制措施，以防MDROs播散。

Distribution and antimicrobial resistance of multidrug resistant organisms in a hospital in 2012

ObjectiveTo investigate clinical distribution and antimicrobial resistance of multidrug resistant organisms(MDROs)in a hospital in 2012, and provide reference for the prevention of MDROs infection.MethodsDistribution and antimicrobial susceptibility testing results of MDROs isolated from patients in a hospital between January and December 2012 were analyzed by targeted monitoring method. ResultsA total of 370 MDROs strains were isolated, isolation rate of gram negative bacilli and gram positive cocci was 92.16%(n=341) and 7.84%(n=29,all were methicillin resistant Staphylococcus aureus［MRSA］)respectively; the top five departments with high MDROs isolation rates were intensive care unit(n=79 isolates), department of neurosurgery (n=65), neurology (n=40) general surgery(n=39), and geriatrics(n=32). Resistant rates of 29 MRSA strains to compound sulfamethoxazole,tigecycline,and rifampicin were all>60%, no vancomycin resistant strain was detected; resistant rates of extended spectrum beta lactamase (ESBLs) producing Escherichia coli and Klebsiella pneumoniae to imipenem were >75%,resistant rates to cefoperazone / sulbactam and amikacin were about 50%; multidrug resistant Pseudomonas aeruginosa and Acinetobacter baumannii were generally not sensitive to antimicrobial agents, multidrug resistant Acinetobacter baumannii were almost pandrug resistant strains.ConclusionThe major MDROs isolated from this hospital are gram negative bacteria, strains are mainly from patients with severe diseases and elderly age. Monitor and control measures on healthcare associated infection should be intensified to prevent the spread of MDROs.