陕西省247所医院抗菌药物使用与病原学送检分析

发布时间：2018-01-02 18:40

本文关键词：陕西省247所医院抗菌药物使用与病原学送检分析　出处：《中华医院感染学杂志》2016年11期 　论文类型：期刊论文

【摘要】：目的调查2015年陕西省各医院住院患者抗菌药物使用、病原学送检及耐药菌的检出,为进一步规范抗菌药物使用提供理论依据。方法采用电子函调方式,对2015年1-12月陕西省247所二级以上医院出院患者抗菌药物使用、病原学送检及耐药菌的检出进行回顾性问卷调查,数据采用SPSS17.0统计软件进行分析。结果下发调查问卷248份,回收有效问卷247份,实查率99.6%;出院患者抗菌药物使用率为53.3%;标本送检率为39.9%,其中血液培养和痰液培养标本送检率分别为17.7%和45.0%;共检出14 226株多药耐药菌,痰液标本中检出9 690株占68.1%,血液标本中检出595株占4.2%;多药耐药菌的耐药率由高到低依次为耐碳青霉烯类鲍氏不动杆菌、耐甲氧西林金黄色葡萄球菌、耐碳青霉烯类铜绿假单胞菌、耐碳青霉烯类肺炎克雷伯菌、耐碳青霉烯类肠杆菌及耐万古霉素肠球菌,分别占46.8%、39.5%、22.5%、4.7%、4.4%及2.4%。结论临床常见的6种耐药菌大部分来自痰液,临床很难判断是否为定植或污染;应进一步加强抗菌药物规范管理,规范采样及送检要求,切实达到以标本培养指导抗菌药物使用,减少细菌耐药的目的。
[Abstract]:Objective to investigate the use of antimicrobial agents, etiological examination and detection of drug-resistant bacteria in hospitals of Shaanxi Province in 2015, so as to provide a theoretical basis for further standardizing the use of antimicrobial agents. A retrospective questionnaire survey was conducted on the use of antimicrobial agents, etiological examination and detection of drug-resistant bacteria in 247 hospitals and above in Shaanxi Province from 2015 to December. The data were analyzed by SPSS17.0 software. Results 248questionnaires were sent out and 247valid questionnaires were returned. The actual investigation rate was 99.66. The utilization rate of antimicrobial agents in discharged patients was 53.3%. The examination rate of blood culture and sputum culture was 17.7% and 45.0 respectively. A total of 14 226 strains of multidrug resistant bacteria were detected, 9 690 strains of sputum and 595 strains of blood samples accounted for 68. 1 and 4. 2%, respectively. The resistant rate of multidrug resistant bacteria from high to low was acinetobacter baumannii, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae. Enterobacterium carbapenems and Enterococcus vancomycin, respectively, accounted for 39.5% of the total of 46.8%. Conclusion most of the 6 common drug-resistant bacteria come from sputum, it is difficult to determine whether they are colonized or contaminated. The standard management of antimicrobial agents should be further strengthened, the requirements of sampling and examination should be standardized, and the aim of guiding the use of antimicrobial agents by specimen culture and reducing the drug resistance of bacteria should be achieved.
【作者单位】：西安交通大学第二附属医院感染管理科;陕西省卫生和计划生育委员会医政医管局;第四军医大学唐都医院疾病预防控制科;
【基金】：陕西省攻关计划基金资助项目(2012K18-01-05)
【分类号】：R446.5
【正文快照】： 多药耐药菌的出现是主要的公共卫生挑战,与抗菌药物的管理直接相关[1]。文献报道中国有66.7%的住院患者使用抗菌药物,而在其他很多国家仅有33.3%[2]。为了解陕西省目前现状,于2016年1月对陕西省247所二级以上医院2015年抗菌药物使用、病原学送检及耐药细菌的检出进行调查。1资

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