鲍曼不动杆菌及铜绿假单胞菌在我院临床各科室感染分布及耐药性分析

目的分析我院铜绿假单胞菌和鲍曼不动杆菌临床分离株的感染分布并分析其耐药特征。方法收集2013年1月至6月住院和门诊患者送检的各类标本并进行分离培养,采用Siemens Microscan WalkAway 40全自动细菌鉴定仪鉴定菌种;采用世界卫生组织(WHO)-NET 5.4软件对病原菌的耐药性进行分析。结果共分离出鲍曼不动杆菌92株,铜绿假单胞菌228株,主要分布于呼吸系统。全院多重耐药性(MDR)鲍曼不动杆菌对亚胺培南、美罗培南(MPM)、氨苄西林/舒巴坦的耐药率分别为12.5%、38.6%、54.5%;而重症监护病房(ICU)MDR的鲍曼不动杆菌的耐药率分别为13.3%、46.7%、53.3%;重症监护室的MDR的铜绿假单胞菌对美罗培南、复方新诺明、氨苄西林/舒巴坦的耐药率分别为20.8%、12.5%、12.5%,全院的MDR铜绿假单胞菌对美罗培南、复方新诺明、氨苄西林/舒巴坦的耐药率分别为20.9%、16.5%、16.5%。结论各临床科室尤其是重症监护室中铜绿假单胞菌及鲍曼不动杆菌感染分布广泛,多重耐药性明显。临床应加强对这两种院感菌耐药性的监控和防止耐药菌株的传播,在经验性用药同时进行病原学检查,根据药敏结果适当调整抗菌药物,以逐步降低耐药状况,避免院内感染和爆发流行。

Distribution and drug resistance analysis of baumanii pseudomonas aeruginosa of Chengdu university affiliated hospital

Objective To analyze tbe distribution and drug resistance of baumannii, pseudomonas aeruginosa in our hospital. Methods Isolation and cultivate the specimens from January to June 2013.Identified pathogens by fully automatic bacterial identification analyzer Siemens Microscan WalkAway 40, analysis the drug resistance of pathogens with WHO-NET 5.4. Results There were 92 strains of baumanii, 228 strains of pseudomonas aeruginosa, which mainly distribution in the respiratory system. The resistance of muhidrug-resistant acinetobacter baumannii on meropenem（MPM） was 38.6%, and in the ICU was 46.7%. The resistance of muhidrug-resistant acinetobacter pseudomonas aeruginosa on （MPM） was i2%, and the rate in the ICU was 20.9%. Conclusion The spread of baumannii and pseudomonas aeruginosa in the hospital were widespread and the resistance rates increased year by year. The hospital should pay more attention on common pathogens popular and drug resistance of hospital infection. Clinical should do more monitoring and control about the resistance of baumannii pseudomonas aeruginosa, clinical empirical medication should be conducted while pathogenic examination. To adjust the antimicrobial agents based on the susceptibility results in order to reduce the resistance and avoid the nosocomial infection and out break.