检验医学与临床
檢驗醫學與臨床
검험의학여림상
Laboratory Medicine and Clinic
2015年
18期
2666-2668
,共3页
细菌%耐药%多重耐药菌%监控
細菌%耐藥%多重耐藥菌%鑑控
세균%내약%다중내약균%감공
bacteria%drug resistance%multi-drug resistant bacteria%monitoring
目的：分析近年来该院多重耐药菌监测情况，为医院多重耐药菌感染预防与控制提供客观依据。方法在以 LIS‐Excel 为开发平台而创建的《细菌耐药监测预警系统》中，对2013年7月至2014年6月该院住院患者送检的1815份标本中分离的阳性菌进行多重耐药菌分析，用 U 检验分析判断不同菌株多重耐药机制的差异显著性。结果在送检的1815份标本中，共检出阳性菌822株，其中多重耐药菌209株，分别为铜绿假单胞菌39．71％、鲍曼不动杆菌30．62％，产超广谱β‐内酰胺酶革兰阴性肠杆菌17．70％、耐甲氧西林金黄色葡萄球菌（MRSA ）11．96％。多重耐药菌在各阳性菌株中的检出比率依次为鲍曼不动杆菌84．21％、金黄色葡萄球菌69．44％、铜绿假单胞菌60．58％、大肠埃希菌48．05％。在铜绿假单胞菌中，以耐碳青霉烯类抗菌药物为主，占73．49％，而鲍曼不动杆菌则以泛耐药株为主，占67．19％。结论该院近年来检出的多重耐药菌以革兰阴性菌为主，铜绿假单胞菌和鲍曼不动杆菌的耐药机制截然不同，前者以耐碳青霉烯类铜绿假单胞菌（CR‐PA）为主，而后者则以泛耐药鲍曼不动杆菌（PDR‐AB）为主。 MRSA 检出率虽仅11．96％，但近年来呈现回升态势，应引起临床关注。
目的：分析近年來該院多重耐藥菌鑑測情況，為醫院多重耐藥菌感染預防與控製提供客觀依據。方法在以 LIS‐Excel 為開髮平檯而創建的《細菌耐藥鑑測預警繫統》中，對2013年7月至2014年6月該院住院患者送檢的1815份標本中分離的暘性菌進行多重耐藥菌分析，用 U 檢驗分析判斷不同菌株多重耐藥機製的差異顯著性。結果在送檢的1815份標本中，共檢齣暘性菌822株，其中多重耐藥菌209株，分彆為銅綠假單胞菌39．71％、鮑曼不動桿菌30．62％，產超廣譜β‐內酰胺酶革蘭陰性腸桿菌17．70％、耐甲氧西林金黃色葡萄毬菌（MRSA ）11．96％。多重耐藥菌在各暘性菌株中的檢齣比率依次為鮑曼不動桿菌84．21％、金黃色葡萄毬菌69．44％、銅綠假單胞菌60．58％、大腸埃希菌48．05％。在銅綠假單胞菌中，以耐碳青黴烯類抗菌藥物為主，佔73．49％，而鮑曼不動桿菌則以汎耐藥株為主，佔67．19％。結論該院近年來檢齣的多重耐藥菌以革蘭陰性菌為主，銅綠假單胞菌和鮑曼不動桿菌的耐藥機製截然不同，前者以耐碳青黴烯類銅綠假單胞菌（CR‐PA）為主，而後者則以汎耐藥鮑曼不動桿菌（PDR‐AB）為主。 MRSA 檢齣率雖僅11．96％，但近年來呈現迴升態勢，應引起臨床關註。
목적：분석근년래해원다중내약균감측정황，위의원다중내약균감염예방여공제제공객관의거。방법재이 LIS‐Excel 위개발평태이창건적《세균내약감측예경계통》중，대2013년7월지2014년6월해원주원환자송검적1815빈표본중분리적양성균진행다중내약균분석，용 U 검험분석판단불동균주다중내약궤제적차이현저성。결과재송검적1815빈표본중，공검출양성균822주，기중다중내약균209주，분별위동록가단포균39．71％、포만불동간균30．62％，산초엄보β‐내선알매혁란음성장간균17．70％、내갑양서림금황색포도구균（MRSA ）11．96％。다중내약균재각양성균주중적검출비솔의차위포만불동간균84．21％、금황색포도구균69．44％、동록가단포균60．58％、대장애희균48．05％。재동록가단포균중，이내탄청매희류항균약물위주，점73．49％，이포만불동간균칙이범내약주위주，점67．19％。결론해원근년래검출적다중내약균이혁란음성균위주，동록가단포균화포만불동간균적내약궤제절연불동，전자이내탄청매희류동록가단포균（CR‐PA）위주，이후자칙이범내약포만불동간균（PDR‐AB）위주。 MRSA 검출솔수부11．96％，단근년래정현회승태세，응인기림상관주。
Objective To analyze the multi‐drug resistant bacteria monitoring situation in our hospital in re‐cent years to provide the objective basis for the prevention and control of multi‐drug resistant bacteria .Methods 822 strains of positive bacteria isolated from 1 815 inpatients′ specimens from July 2013 to June 2014 were performed the multiple‐drug resistance bacterial analysis in the bacterial drug resistance monitoring system created in the LIS‐Excel development platform .The difference significance of multi‐drug resistance mechanism among different strains was an‐alyzed by the U test .Results In 1 815 detected specimens ,822 strains of positive bacteria were detected ,in which 209 strains were multi‐drug resistant bacteria ,Pseudomonas aeruginosa accounting for 39 .71% ,Acinetobacter baumanii for 30 .62% and extended spectrum beta‐lactamases producing gram‐negative enteric bacilli for 17 .70% and methicil‐lin‐resistant staphylococcus aureus for 11 .96% ,respectively .In the different positive strains ,the detection rate of multi‐drug resistant bacteria were in turn acinetobacter baumanii(84 .21% ) ,staphylococcus aureus(69 .44% ) ,Pseud‐omonas aeruginosa(60 .58% ) and E .coli(48 .05% ) ,respectively .In Pseudomonas aeruginosa ,carbapenem resistant antimicrobial drugs were predominant ,accounting for 73 .49% ,while Acinetobacter baumanii was mainly pandrug re‐sistant strains ,accounting for 67 .19% .Conclusion The detected multi‐drug resistant bacteria in recent years are mainly gram‐negative bacteria .The drug‐resistance mechanism of pseudomonas aeruginosa and Acinetobacter bauma‐nii is entirely different .Pseudomonas aeruginosa is given priority to CR‐PA and Acinetobacter baumanii is given pri‐ority to PDR‐AB .Although detected MRSA accounts for only 11 .96% ,but which shows the rebound trend in recent years and should arouse clinical attention .
