当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2015年
3期
136-137
,共2页
冯琳涵%徐修礼%刘家云%郝晓柯
馮琳涵%徐脩禮%劉傢雲%郝曉柯
풍림함%서수례%류가운%학효가
细菌%医院内感染%抗菌药物%耐药性
細菌%醫院內感染%抗菌藥物%耐藥性
세균%의원내감염%항균약물%내약성
Bacteria%Nosocomail infection%Antimicrobial agents%Drug resistance
目的：了解医院内感染病原菌的分布及耐药状况，为临床合理用药提供依据。方法常规培养分离鉴定，应用VITEKI和phoenix100全自动细菌鉴定分析仪系统鉴定菌株；药敏试验采用K-B纸片扩散法，根据CLSI规定的标准进行。结果2013年共检出6681株病原菌，临床分离的细菌主要以革兰阴性菌为主，大肠埃希菌、金黄色葡萄球菌、鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌为分离菌株的前五位，分离率分别为17.2%、14.19%、13.31%、12.26%、9.52%，产ESBLs的大肠埃希菌和肺炎克雷伯菌分离率分别为56.94%、41.53%；耐甲氧西林金黄色葡萄球菌(MRSA)分离率为59.18%。检出耐万古霉素、耐利奈唑胺的金黄色葡萄球菌各1株。结论大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和金黄色葡萄球仍是临床院内感染的重要病原菌，且对多种抗生素都处于比较高水平的耐药率，有逐年升高的趋势。临床微生物实验室应加强医院内重要感染病原菌的耐药性检测，临床应根据药敏结果和患者自身的感染状况制定出合理的个性化治疗方案，并高度重视多药耐药菌感染者的有效隔离，以防控耐药菌的扩散和流行。
目的：瞭解醫院內感染病原菌的分佈及耐藥狀況，為臨床閤理用藥提供依據。方法常規培養分離鑒定，應用VITEKI和phoenix100全自動細菌鑒定分析儀繫統鑒定菌株；藥敏試驗採用K-B紙片擴散法，根據CLSI規定的標準進行。結果2013年共檢齣6681株病原菌，臨床分離的細菌主要以革蘭陰性菌為主，大腸埃希菌、金黃色葡萄毬菌、鮑曼不動桿菌、銅綠假單胞菌、肺炎剋雷伯菌為分離菌株的前五位，分離率分彆為17.2%、14.19%、13.31%、12.26%、9.52%，產ESBLs的大腸埃希菌和肺炎剋雷伯菌分離率分彆為56.94%、41.53%；耐甲氧西林金黃色葡萄毬菌(MRSA)分離率為59.18%。檢齣耐萬古黴素、耐利奈唑胺的金黃色葡萄毬菌各1株。結論大腸埃希菌、肺炎剋雷伯菌、銅綠假單胞菌、鮑曼不動桿菌和金黃色葡萄毬仍是臨床院內感染的重要病原菌，且對多種抗生素都處于比較高水平的耐藥率，有逐年升高的趨勢。臨床微生物實驗室應加彊醫院內重要感染病原菌的耐藥性檢測，臨床應根據藥敏結果和患者自身的感染狀況製定齣閤理的箇性化治療方案，併高度重視多藥耐藥菌感染者的有效隔離，以防控耐藥菌的擴散和流行。
목적：료해의원내감염병원균적분포급내약상황，위림상합리용약제공의거。방법상규배양분리감정，응용VITEKI화phoenix100전자동세균감정분석의계통감정균주；약민시험채용K-B지편확산법，근거CLSI규정적표준진행。결과2013년공검출6681주병원균，림상분리적세균주요이혁란음성균위주，대장애희균、금황색포도구균、포만불동간균、동록가단포균、폐염극뢰백균위분리균주적전오위，분리솔분별위17.2%、14.19%、13.31%、12.26%、9.52%，산ESBLs적대장애희균화폐염극뢰백균분리솔분별위56.94%、41.53%；내갑양서림금황색포도구균(MRSA)분리솔위59.18%。검출내만고매소、내리내서알적금황색포도구균각1주。결론대장애희균、폐염극뢰백균、동록가단포균、포만불동간균화금황색포도구잉시림상원내감염적중요병원균，차대다충항생소도처우비교고수평적내약솔，유축년승고적추세。림상미생물실험실응가강의원내중요감염병원균적내약성검측，림상응근거약민결과화환자자신적감염상황제정출합리적개성화치료방안，병고도중시다약내약균감염자적유효격리，이방공내약균적확산화류행。
Objective To investigate the distribution of pathogenic bacteria and drug resistance in our hospital in order to provide evidence for clinical rational drug use.Methods All isolates were identified by routine procedure and VITEK II and phoenix100 microbe automatic system, and drug susceptibility tests used K-B paper disk diffusion method in accordance with the CLSI standards.Results 6681strains of pathogenic bacteria were detected in 2013 year, clinical isolates of bacteria were mainly Gram-negative bacteria, Escherichia coli (E.Co), Klebsiella pneumonia(Kpn), Pseudomonas aeruginosa (Pae), Acinetobacter baumannii (Aba), Staphylococcus aureus (Sau) isolated from five for the year, the separation rate respectively is 17.2%、14.19%、13.31%、12.26%、9.52%, Escherichia coli and Klebsiella pneumoniae producing ESBLs throughout the year were 56.94%, 41.35%; methicillin-resistant Staphylococcus aureus (MRSA) isolates were 59.18%. The detection resistant to vancomycin, linezolid-resistant Staphylococcus aureus each one.Conclusion The E.coli、KPN、PAE、ABA and STA are main pathogens in nosocomial infection, and to antibiotics has been showed in a high level and there is an increasing trend of rate of drug resistantance. It is suggested to enhance the detection of multi-drug resistant bacteria. meanwhile clinic should be according to drug sensitive test results and patient self-infection situation to make rational optimization treatment,and taking effective isolation measures against multi drug resistant bacteria in order to prevent and control its proliferation.
