2012 - 2016年南昌市第三医院医院感染病原菌分布及耐药菌分析

目的 通过总结分析南昌市第三医院近5年医院感染主要病原菌分布及抗菌药物的耐药性，为临床诊疗提供依据。方法 采用西门子MifcroScan WalkAway - 40 plus全自动细菌检定药敏分析仪对2012年1月 - 2016年12月医院感染患者标本进行细菌鉴定及药敏试验，用SPSS13.0分析耐药趋势。结果 5年共检出医院感染病原菌2 206株，前3位依次是大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌，其中大肠埃希菌5年多重耐药菌分布率最高，且差异有统计学意义（P＜0.05），在2012 - 2013年较高，2014年下降，2016年回升,其对丁胺卡那、亚胺培南、美罗培南、头孢西丁、哌拉西林/他唑巴坦、阿莫西林/克拉维酸耐药率＜30%；肺炎克雷伯菌对哌拉西林/他唑巴坦、阿莫西林/克拉维酸的耐药率＞26%；铜绿假单胞菌在部分年份对亚胺培南、美罗培南、哌拉西林/他唑巴坦、庆大霉素等耐药率＞30%。结论 医院感染主要病原菌耐药率依然较高，仍需进一步加强细菌耐药性监测。

Analysis on the distribution of major pathogens and the trends of drug resistance causing nosocomial infections from 2012 to 2016 in the third hospital of Nanchang

Objective To understand the distribution of major pathogens and analyze the trend of anti-bacteria drug resistance in the third hospital of Nanchang for recent 5 years, which will provide useful information in clinic. Methods We used WalkAway-40 plus bacteria susceptibility analyzer to analyze the samples from Jan 2012 to Dec 2016. SPSS 13.0 was used for analyzing the trend for drug resistance. Results About 2206 samples were detected, and the top three types are Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. Escherichia coli has the highest occurrence rate for multi-drug resistance subtype with statistical significance (P<0.05). The highest occurrence rate happened between 2012 and 2013, quickly decreased in 2014, and returned back after 2016. Imipenem, Meropenem, Cefoxitin, Piperacillin/Tazobactam and Amoxicillin/Clavulanic acid bring the drug resistance rate of Escherichia coli lower than 30%. The drug resistance rates for Piperacillin/Tazobactam and Amoxicillin/Clavulanic acid are more than 26% of Klebsiella pneumoniae. For Pseudomonas aeruginosa, the drug resistance rate after using Imipenem, Meropenem, Piperacillin/Tazobactam, and Gentamicin is more than 30% for some years. Conclusion The drug resistance rate of major pathogens is still at a high level; therefore, we need to continue monitor the drug resistance and properly apply the antibiotics.