摘要
目的 回顾性分析广东省第二中医院近5年多重耐药菌的种类、标本类型及临床科室分布,以及其耐药情况,为临床多重耐药菌的治疗、防控提供科学的指导。方法 统计2011~2015年该医院实验室细菌培养阳性标本,分析各菌种中多重耐药菌产生的种类、比例、耐药情况及其在临床标本、科室之间的分布情况。结果 5年间分离的多重耐药菌有2 568例,占阳性标本的37.41%,其中数量排在前5位的为大肠埃希菌、鲍曼不动杆菌、金黄色葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌;多重耐药菌阳性率较高的标本是痰液、中段尿、血液、分泌物、脓液,从导管头、耳分泌物中分离阳性率较低（P〈0.05）;多重耐药菌在病区之间存在差异,其中重症监护室、呼吸科、外科最高,脾胃科和乳腺科最低（P〈0.05）;多重耐药菌的耐药性发生较广泛,对β-内酰胺类、氨基糖苷类抗菌药物的耐药性较高,对复合抗菌药物如复方磺胺甲噁唑、含酶类抑制剂的敏感性相对较高。结论 多重耐药菌在临床上越来越多见,阳性率逐年增高,耐药菌株分布广,临床科室应予高度重视。合理、科学地使用抗菌药物,严格控制多重耐药菌的传播,加强此类患者的隔离,对有效防控多重耐药菌的扩散有重要意义。
Objective To investigate the types ,specimen types ,department distribution and drug resistance of multi‐drug resist‐ant bacteria in our hospital during the recent 5 years to provide the scientific guidance for the clinical treatment ,prevention and con‐trol of multi‐drug resistant bacteria .Methods The specimens of laboratory bacterial culture positive during 2011-2015 were col‐lected ,and analyzed on the types ,proportion and drug resistance situation of multi‐drug resistant bacteria and their distribution in clinical specimens and clinical departments .Results A total of 2 568 strains of multi‐drug resistant bacteria were isolated and ac‐counted for 37 .41% the positive specimens ,in which top 5 bacteria were Escherichia coli ,Acinetobacter baumannii ,Staphylococcus aureus ,Klebsiella pneumoniae and Pseudomonas aeruginosa;the sputum ,midstream urine ,blood and secretions had the higher posi‐tive rate of multi‐drug resistant bacteria ,while the secretions from the catheter tip and ear discharge had the lower positive rate（P〈0 .05）;the multi‐drug resistant bacteria had difference among different departments ,in which ICU ,respiratory department and sur‐gery department were highest ,while the lowest was in the spleen and stomach department and breast department ;the resistance of multi‐drug resistant bacteria occurred over a wide range ,which had higher resistance to beta lactam and aminoglycosides and had higher sensitivity to compound antibacterial drugs such as sulfamethoxazole antibiotics and enzyme inhibitors .Conclusion Multi‐drug resistant bacteria are more and more common in clinic .The positive rate is increased year by year .The drug resistant strains widely distributed .The clinical departments should pay high attention to .Rational and scientific use of antibacterial drugs ,strict control of multi‐drug resistant bacterial spread and strength of the patients′isolation have an important significance to effectively prevent and control the multi‐drug resistant bacterial spread .
出处
《国际检验医学杂志》
CAS
2016年第16期2280-2282,共3页
International Journal of Laboratory Medicine
关键词
多重耐药菌
流行病学
耐药性
multi-drug resistance
epidemiology
drug resistance
