多重耐药菌感染的临床分析和耐药性监测

目的通过多重耐药菌(MDRB)株的分离和耐药谱检测,为临床有效控制MDRB感染提供依据。方法常规分离培养并鉴定菌种;用自动肉汤稀释法测最低抑菌浓度(MIC)值进行药敏试验,根据标准筛选MDRB并计算耐药率,同时追踪分析其易感因素。结果5453份标本中检出MDRB株573株,检出率10.5%;主要多重耐药菌为大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯菌五种细菌。绝大部分MDRB耐受10种以上常用抗菌药物。肠杆菌科细菌对亚胺培南的耐药率为4.4%,而非发酵菌为13.6%。革兰阴性MDRB对阿米卡星、庆大霉素、磷霉素和氟喹诺酮敏感;多重耐药葡萄球菌对万古霉素和利福平敏感。其易感因素包括住院时间超过两周、使用多种抗生素特别是三代头孢使用超过7d以上、以及各种有创操作和导管的留置。结论MDRB对常用抗菌药物几乎全部耐受,应高度重视抗菌药物的合理应用。

Clinical Analysis of Multiply Antimicrobial-resistant Bacteria and Monitoring of Antimicrobial Resistance

Objective To analyze the multiply antimicrobial-resistant bacteria (MDRB) and monitor the antimicrobial resistance,and to provide the reference for controlling the infection of drug-resistant bacteria. Methods Bacteria were isolated and identified routinely,and antimicrobial susceptibility test was performed by auto-broth dilution test. Drug-resistance rate was calculated,and the predisposing factors were analyzed. Results Altogether 573 (10.5%) strains were isolated from 5,453 specimens,and the majority of...