2010年-2012年柳州地区常见多重耐药菌临床分布特征分析

目的分析柳州地区常见多重耐药茵（multi-drugresistantorganism，MDRO）临床分布特征，为预防和控制MDRO医院感染提供科学依据。方法采用回顾性调查法分析2010年9月～2012年8月柳州地区常见MDRO的临床分布特征。标本采集、运送和培养按照《全国临床检验操作规程》（第3版）进行。采用生物梅里埃ATBExpression半自动微生物鉴定和药敏系统或天地人半自动微生物鉴定和药敏系统对分离的MDROs进行鉴定和药敏检测。结果2010年9月～2012年8月检测的标本共29940例，分离的致病菌为8541株，其中常见MDRO为62株，致病菌检出率为28．5％，常见MDRO检出率为0．2％。检出率前三的常见多重耐药茵为MRSA（61．3％），CR-AB（33．9％）和MDR-PA（4．8％）。MDRO科室来源构成比前三位为肺病科（41．9％）、针灸科（14．5％）和重症监护室（11．3％）；MDRO标本来源构成比前三位为痰（45．2％）、BALF（30．6％）和分泌物（9．7％）。结论该地区常见MDRO检出率低，但临床分布不均。

Analysis of Clinical Distribution Characteristics of Common MDROs Isolated in Liuzhou District from 2010 to 2012

Objective To analyze the clinical distribution characteristics of MDROs in Liuzhou district and further provide sci- entific evidences for preventing and controlling nosocomial infection caused by MDROs. Methods Retrospective investiga- tion study method was employed to analyse the clinical distribution characteristics of strains of MDROs in Liuzhou district from 2010. 9 to 2012.8. The clinical samples were collected, transported, and cultivated according to 《the operation proce- dures of national laboratory diagnostics》（3th edition ）. The identification and antibiotics susceptiblity tests of MDROs were performed using the semi-automatic microbiologic assay and drug sensitive system of Biomerieux or RDR Co. , Ltd. Results Totally,8 541 strains of pathogenic bacteria were isolated from 29 940 samples from 2010.9 to 2012.8, among which 62 strains of pathogenic bacteria were MDROs, the detection rate of pathogenic bacteria and MDROs were 28.5 % and 0. 2 respectively. The common MDROs were MRSA （61.3%）,CR-AB （33.9%） and MDR-PA （4. 8%）. The top three depart- ments were Department of Pulmonary disease （41.9 %）, Department of Acupuncture and moxibustion （14.5%） and ICU （11.3%） according to the constituent ratio of MDROs＇ department-specific distribution. The top three sample types were sputum （45.2%）,BALF （30. 6%） and secrete （9.7%） according to the constituent ratio of MDROs＇sample-specific distri- bution. Conclusion The detection rate of common MDROs in the hospital was low,but the clinical distribution of MDROs was uneven.