武汉大学人民医院多重耐药的病原菌分布及耐药特点

发布时间：2018-07-16 23:06

【摘要】：目的探讨武汉大学人民医院住院患者多重耐药菌的分布特点及耐药情况,为院感部门采取多重耐药菌感控措施及临床抗生素的合理使用提供实验室依据。方法回顾性分析2014年9月-2015年9月本院多重耐药细菌的目标性监测资料,统计学分析采用WHONET 5.6和Excel。结果临床共分离鉴定病原菌7 391株,多重耐药菌1 548株,检出率为20.94%,其中多重耐药鲍曼不动杆菌(28.81%)、产ESBLs大肠埃希菌(24.61%)、多重耐药铜绿假单胞菌(14.53%),产ESBLs肺炎克雷伯菌(12.79%)和耐甲氧西林金黄色葡萄球菌MRSA(12.22%);多重耐药菌株主要分布在重症医学科、呼吸内科和神经内科,共计1 006株,占64.99%;在检出多药耐药菌株标本中,痰占52.95%,尿液占16.69%。鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率为71.4%,对其余抗生素耐药率均高于86.7%;大肠埃希菌对左氧氟沙星耐药率为53.6%,对阿米卡星的耐药率为3.0%;铜绿假单胞菌对氨曲南的耐药率为47.5%;肺炎克雷伯菌对哌拉西林/他唑巴坦的耐药率为12.3%;金黄色葡萄球菌对青霉素、红霉素和克林霉素耐药率分别为96.5%,66.1%和60.0%,未发现对万古霉素和替考拉宁耐药的金黄色葡萄球菌;检出13株对万古霉素耐药的肠球菌。结论多重耐药菌是医院感染的主要致病菌,综合医院应积极主动进行预防和控制,加强抗生素的管理及合理使用。
[Abstract]:Objective to investigate the distribution characteristics and drug resistance of multidrug resistant bacteria in hospitalized patients of people's Hospital of Wuhan University, and to provide laboratory basis for multidrug resistant bacteria control measures and rational use of clinical antibiotics in hospital departments. Methods the target surveillance data of multidrug resistant bacteria in our hospital from September 2014 to September 2015 were analyzed retrospectively. WHONET 5.6 and Excel were used for statistical analysis. Results A total of 7 391 strains of pathogenic bacteria and 1 548 strains of multidrug resistant bacteria were isolated and identified. The detection rate was 20.94, including Acinetobacter baumannii (28.81%), Escherichia coli (24.61%), Pseudomonas aeruginosa (14.53%), Klebsiella pneumoniae (12.79%) and MRSA (12.22%). There were 1 006 strains (64.99%) in respiratory and neurology departments, and 52.95% in sputum and 16.69% in urine. The resistance rate of Acinetobacter baumannii to cefoperazone / sulbactam was 71.4, and to other antibiotics was higher than 86.7; Escherichia coli to levofloxacin 53.6 and amikacin to 3.0; Pseudomonas aeruginosa to amitrotrix. The resistance rate of Klebsiella pneumoniae to piperacillin / tazobactam was 12.3%, Staphylococcus aureus to penicillin, The resistant rates of erythromycin and clindamycin were 96. 5% and 60. 0%, respectively. No vancomycin and teicoplanin resistant Staphylococcus aureus were found, and 13 strains of Enterococcus were found to be resistant to vancomycin. Conclusion multidrug resistant bacteria are the main pathogens of nosocomial infection. General hospitals should take the initiative to prevent and control antibiotics and strengthen the management and rational use of antibiotics.
【作者单位】：武汉大学人民医院检验科;
【基金】：国家临床重点专科(财社2010305)
【分类号】：R446.5

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