某综合医院医院感染病原菌临床分布及耐药情况

目的了解某综合医院医院感染病原菌临床分布特征及耐药情况。方法收集该院2012年5月—2015年5月医院感染患者的病例资料,对其病原菌分布及其耐药情况进行统计分析。结果 183 850例患者共发生医院感染6 563例,医院感染发生率为3.57%,其中445例患者检出2种及2种以上病原菌,375例患者检出2种病原菌(84.27%),2种病原菌均是以革兰阴性(G-)杆菌为主(132例)。送检标本4 478份,培养阳性标本2 503份,培养阳性率为55.90%;分离病原菌2 755株,其中G-杆菌1 713株(62.18%),革兰阳性(G+)球菌732株(26.57%),酵母样真菌304株(11.03%),厌氧菌6株(0.22%)。以神经内科分离病原菌居多(524株,19.02%),病原菌主要分离自痰标本(1 340株,48.64%)。耐碳青霉烯类大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌检出率分别为0.39%(2/510)、1.66%(3/181)、59.14%(207/350)、5.29%(11/208);耐甲氧西林金黄色葡萄球菌(MRSA)检出率为21.55%(25/116)。结论医院感染病原菌中多重耐药菌较多,应了解科室感染病原菌分布特点及流行情况,做好多重耐药菌监测,实施接触隔离措施,防止医院感染暴发。

Clinical distribution and antimicrobial resistance of pathogens causing healthcare associated infection in a comprehensive hospital

ObjectiveTo understand the clinical distribution characteristics and antimicrobial resistance of pathogens causing healthcare associated infection(HAI) in a comprehensive hospital. MethodsClinical data of patients with HAI in this hospital between May 2012 and May 2015 were collected, the distribution and antimicrobial resistance of pathogens isolated from patients were analyzed.ResultsA total of 6 563 cases of HAI occurred among 183 850 patients, incidence of HAI was 3.57%, 445 patients were isolated at least two kinds of pathogens, 375（84.27%） patients were isolated two kinds of pathogens, 132 of whom were infected with both gram negative bacilli. 4 478 specimens were sent for pathogenic detection, 2 503 (55.90%) of which were isolated pathogens; a total of 2 755 pathogens were isolated, including 1 713(62.18%) strains of gram negative bacilli, 732(26.57%) gram positive cocci, 304(11.03%) yeast like fungi, and 6(0.22%) anaerobic bacteria. 524(19.02%）strains were mainly from patients in department of neurology. The main specimen was sputum (n=1 340, 48.64%). The isolation rates of carbapenem resistant Escherichia coli(CREC), Klebsiella pneumoniae (CRKP), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa(CRPA) were 0.39%（2/510）, 1.66%（3/181）, 59.14%（207/350）, and 5.29%（11/208）respectively；isolation rate of methicillin resistant Staphylococcus aureus (MRSA) was 21.55%（25/116）. ConclusionMultidrug resistant organisms causing HAI are various, it is necessary to understand distribution characteristics and prevalence of pathogens, monitor multidrug resistant organisms, and implement contact isolation measures, so as to prevent the outbreak of HAI.