某三甲医院常见多重耐药菌流行趋势分析

目的研究某三甲医院常见多重耐药菌变化趋势，为临床合理使用抗菌药物及医院感染的防控提供依据。方法回顾性分析2015-2017年该医院分离的病原菌及耐药情况，数据处理采用WHONET 5.6和SPSS 20.0软件。结果该医院肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌的构成比呈现上升趋势（P < 0.05~P < 0.01）；医院常见多重耐药菌包括产超广谱β内酰胺酶（ESBLs）大肠埃希菌、产ESBLs肺炎克雷伯菌、耐甲氧西林金黄色葡萄球菌（MRSA）、耐碳青霉烯类大肠埃希菌（CREO）、耐碳青霉烯类肺炎克雷伯菌（CRKP）、耐碳青霉烯类鲍曼不动杆菌（CRAB）、耐碳青霉烯类铜绿假单胞菌（CRPA）；2015-2017年常见多重耐药菌构中，产ESBLs的大肠埃希菌、CRAB、产ESBLs的肺炎克雷伯菌构成比呈下降趋势（P < 0.05~P < 0.01），而CRKP、MRSA、CRPA构成比呈上升趋势（P < 0.05~P < 0.01）；肺炎克雷伯菌和铜绿假单胞菌对碳青霉烯类抗菌药物的耐药性呈增长趋势（P < 0.01）。结论该院常见病原菌耐药情况严重，其中肺炎克雷伯菌和铜绿假单胞菌对碳青霉烯类抗菌药物耐药性快速增长，医院应加强多重耐药菌的监管，遏制其感染和传播。

Analysis of epidemic trend of common multi-drug resistant bacteria in a tertiary hospital

ObjectiveTo study the variation trend of common multi-drug resistant bacteria in a tertiary hospital, and provide the evidence for the rational use of antimicrobial drugs and prevention and control of nosocomial infections.MethodsThe data of pathogenic bacteria and drug-resistance in a hospital from 2015 to 2017 were retrospectively analyzed, and analyzed using the WHONET5.6 and SPSS20.0 software.ResultsThe composition ratio of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus in the hospital analyzed an upward trend (P < 0.05 to P < 0.01).The extended-spectrum β-lactamase (ESBLs) Escherichia coli, ESBLs-producing Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus, carbapenem-resistant large intestine Escherichia coli, carbapenem-resistant Klebsiella pneumoniae, carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Pseudomonas aeruginosa were the common multiple drug resistant bacteria in the hospital.Among common multi-drug resistant bacteria from 2015 to 2017, the composition ratio of ESBLs Escherichia coli, carbapenem-resistant Acinetobacter baumannii and ESBLs-producing Klebsiella Pneumoniae, methicillin-resistant Staphylococcus aureus decreased (P < 0.05 to P < 0.01), while the composition ratio of carbapenem-resistant Klebsiella, methicillin-resistant Staphylococcus aureus, and carbapenem-resistant Pseudomonas aeruginosa increased (P < 0.05 to P < 0.01).The drug-resistance of klebsiella Pneumoniae and Pseudomonas aeruginosa to carbapenems increased (P < 0.01).ConclusionsThe resistance of common pathogens in the hospital is serious.The drug-resistance of Klebsiella pneumoniae and Pseudomonas aeruginosa to carbapenems increases rapidly, the hospital should strengthen the supervision of antimicrobial agents and multi-drug resistant bacteria to control the infection and spread of multi-drug resistant bacteria.