住院患者多重耐药菌监测状况分析

目的了解我院住院患者多重耐药菌分布特点及耐药情况。方法收集我院2014年1月1日-12月31日住院患者送检微生物室的各类标本,以分离出的非重复细菌为研究对象,菌株鉴定采用法国生物梅里埃VITEK-2系统进行,根据美国临床实验室标准化协会标准判断多重耐药菌。使用SPSS19.0软件进行数据分析。结果 2014年1月1日-12月31日住院患者各类标本分离出非重复细菌为8068株,其中多重耐药菌为4675株,占57.94%,重点监测的6种多重耐药菌占比分别为耐碳青霉稀类的鲍曼不动杆菌占14.35%(671/4675)、耐碳青霉稀类的铜绿假单胞菌占10.37%(485/4675)、耐甲氧西林的金黄色葡萄球菌(MRSA)占11.55%(540/4675)、耐碳青霉稀类的肺炎克雷伯菌占3.89%(182/4675)、耐碳青霉稀类的大肠埃希氏菌占2.46%(115/4675)、耐万古霉素肠球菌(VER)占1.05%(49/4675)。检出多重耐药菌株最多的前3位科室分别为综合ICU 25.18%(1177/4675)、呼吸内科17.18%(803/4675)、干部病房15.25%(713/4675)。结论住院患者多重耐药菌检出率较高,尤其是耐碳青霉烯类杆菌的检出较高,定期进行细菌耐药监测可以为临床抗生素使用提供依据。

Monitoring result and analysis of multi-drug resistant patients

Objective To investigate the bacteria distribution and features of multi-drug resistant patients. Methods The clinical date and non-duplicate isolates from hospitalized patients were collected from January 1,2014 to December 31,2014. Clinical and Laboratory Standards Institute(CLSI)was adopted to study MDRO. All date were analyzed by WHONET 5. 4 software. Results Of the 8068 clinical isolates,multi-drug resistant organisms were 4675(57. 94% ),and the 6 most common methicillin-resistant bacteria isolates were Acinetobacter baumannii (14. 35% ),Pseudomonas aeruginosa( 10. 37% ),Staphylococcus aureus ( 11. 55% ), Klebsiella pneumonia (3. 89% ),Escherichia coli(2. 46% )and Enterococcus faecalis(1. 05% ). Multi-drug resistant organism were mainly in intensive care unit(25. 18% ),respiratory(17. 18% )and departments of health(15. 25% ). Conclusion We should pay attention to infection with MDRO in hospitalized patients. Regular surveillance of bacterial resist-ance could provide practical guidance of rational selection of antimicrobial agents for clinicians.