我院2017年多重耐药菌分布特点及耐药性分析

[摘要]目的：探讨我院住院患儿多重耐药菌分布特点及耐药性，为临床合理使用抗菌药物提供依据。方法：回顾性分析我院2017年多重耐药菌感染病例资料，并对结果进行统计分析。结果：我院2017年共检出多重耐药菌368株，检出率32.20%，主要为大肠埃希菌（31.80%）、肺炎克雷伯菌（31.25%）、耐甲氧西林金黄色葡萄球菌（15.49%）、耐甲氧西林凝固酶阴性葡萄球菌（15.76%）；多重耐药菌标本主要为痰液（198例）、血液（102例）、脓液（25例）、中段尿（16例）、分泌物（14例），主要集中在新生儿内科NICU 136例（36.96%）、重症监护室（PICU）87例(23.64%)、新生儿外科ICU 67例（18.21%）。大肠埃希菌对美罗培南、亚胺培南敏感，肺炎克雷伯菌对美罗培南、亚胺培南敏感性下降，鲍曼不动杆菌对美罗培南、亚胺培南耐药率达到82.34%；革兰阳性多重耐药菌对利奈唑胺和万古霉素敏感。结论：多重耐药菌已成为医院内感染的重要病原菌，应加强多重耐药菌的监管，加强抗菌药物的合理使用，注意手卫生，减少或避免多重耐药菌的发生。

Distribution Characteristics and Drug Resistance of Multi-Drug Resistant Bacteria in Our Hospital in 2017

[Abstract] Objective: To probe into the distribution characteristics and drug resistance of multi-drug resistant bacteria in our hospital, so as to provide basis for rational use of antibiotics in clinic. Methods: Retrospective analysis was conducted on the data of multi-drug resistant bacteria infection cases in our hospital in 2017, and statistical analysis was conducted on the results. Results: A total of 368 strains of multi-drug resistant bacteria were detected in our hospital in 2017, with the detection rate of 32.20%, mainly including Escherichia coli (31.80%), Klebsiella pneumoniae (31.25%), methicillin-resistant Staphylococcus aureus (15.49%) and methicillin-resistant coagulase-negative Staphylococci (15.76%). The samples of multi-drug resistant bacteria were mainly sputum (198 cases), blood (102 cases), pus (25 cases), midstream urine (16 cases), and secretions (14 cases), mainly concentrated in 136 cases in neonatal intensive care unit (ICU) (36.96%), 87 cases in pediatric intensive care unit (PICU) (23.64%), and 67 cases in neonatal surgical ICU (18.21%). E. coli was sensitive to meropenem and imipenem. K. pneumoniae had decreased sensitivity to meropenem and imipenem. The resistance of Acinetobacter baumannii to meropenem and imipenem reached 82.34%. Gram-positive multi-drug resistant bacteria were sensitive to linezolid and vancomycin. Conclusion: Multi-drug resistant bacteria have become an important pathogen of nosocomial infections. It is necessary to strengthen the supervision of multi-drug resistant bacteria, promote the rational use of antibiotics, pay attention to hand hygiene, and reduce or avoid the occurrence of multi-drug resistant bacteria.