摘要
目的通过分析医院呼吸科发生多药耐药菌感染的相关因素，探讨多药耐药菌感染的防治措施，以预防控制多药耐药菌感染。方法选取呼吸科2012年3月-2013年2月多药耐药菌感染患者74例，常规进行痰培养及药敏检测；药敏试验采用MIC法，采用法国生物梅里埃公司VITEK-2 Compact全自动细菌分析仪及其药敏板进行筛选，按NCCLS标准判断药敏试验结果。结果共检出多药耐药菌78株，前5位菌株依次为大肠埃希菌、肺炎链球菌、铜绿假单胞菌、表皮葡萄球菌、鲍氏不动杆菌，分别占25．64％、15．38％、14．10％、12．82％、10．26％；主要革兰阳性菌对万古霉素、利奈唑胺保持较高的抗菌活性，耐药率均为0，主要革兰阴性菌对亚胺培南、阿米卡星保持较高的抗菌活性，耐药率0～37．5％，对其他抗菌药物则出现不同程度的耐药。结论应加强对多药耐药菌的目标性检测，及时发现，早期诊断，一旦发现耐药菌株，应根据药敏试验选用敏感的抗菌药物进行治疗，严格执行手卫生，及时进行消毒隔离措施，有效避免感染的播散。
OBJECTIVE To analyze the related factors for multidrug-resistant bacteria infections in respiratory department and explore the prevention measures for multidrug-resistant bacteria infections so as to prevent the multidrug-resistant bacteria infections. METHODS Totally 74 patients with multidrug-resistant bacteria infections, who were treated in the respiratory department from Mar 2012 to Feb 2013, were enrolled in the study, then the routine sputum culture and the drug susceptibility testing were performed, the drug susceptibility testing was performed with the use of MIC method, the isolated bacteria were screened out by using VITEK-2 Compact automatic bacterial analyzer of BioMerieux, France and the drug susceptibility plate, and the result of the drug susceptibility testing was interpreted according to the standards of NCCLS. RESULTS A total of 78 strains of multidrug-resistant bacteria have been isolated, among which the Escherichia coli, Streptococcus pneumoniae, Pseudomonas aerugi- nosa, Staphylococcus aureus, and Acinetobacter baumannii ranked the top five species, accounting for 25. 64%, 15.38%, 14.10%, 12.82%, and 10.26%, respectively. The main gram-positive bacteria remained high antibacterial aetivity against vancomycin and linezolid, with the drug resistance rates of 0; the main gram-negative bacteria remained high antibacterial activity against imipenem and amikacin, with the drug resistance rate varying from 0 to 37.5 %, and the strains varied in the drug resistance to other antibiotics. CONCLUSION It is necessary to strengthen the targeted detection of the multidrug-resistant bacteria, with the detection in a timely manner, diagnosis in a early stage; once the drug-resistant strains emerge, it is necessary to choose sensitive antibiotics based on the result of drug susceptibility testing, strictly implement the hand hygiene, and take disinfection and isolation measures in a timely manner so as to effectively avoid the spread of infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第17期4379-4381,共3页
Chinese Journal of Nosocomiology
基金
山东省聊城市科技计划基金项目(201206350008)
关键词
多药耐药菌
痰培养
感染
相关因素
Multidrug-resistant bacterial Sputum culture Infection Related factor
