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目的了解本院多重耐药菌(MDRO)分布及耐药情况。方法选取2015年1~12月进行病原微生物培养标本共3063份,包括血液、体液、尿液、大便、分泌物、痰、支气管灌洗液等标本均上送市人民医院检验科细菌室进行检测培养。结果对50株MDRO按数量、分布进行分析,前三位分别是大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌,分别占60.0%、12.0%、8.0%。大肠埃希菌对氨苄西林耐药率高达96.7%,对氨苄西林/舒巴坦、头孢唑林、环丙沙星、左氧氟沙星、复方磺胺甲噁唑片(商品名:复方新诺明)、头孢曲松耐药均>73%,对头孢呋辛、头孢哌酮/舒巴坦、庆大霉素耐药率均>40%。其对呋喃妥因、阿米卡星、美罗培南、亚胺培南、头孢呋辛酯均敏感。鲍曼不动杆菌对头孢唑林及呋喃妥因耐药率高达60%,其对头孢呋辛、头孢呋辛酯、氨苄西林耐药率为50%,其对头孢他啶、氨苄西林/舒巴坦、头孢哌酮/舒巴坦、氨曲南、庆大霉素、妥布霉素、环丙沙星、左氧氟沙星、美罗培南、亚胺培南、复方新诺明、多粘菌素B、哌拉西林/他唑巴坦均敏感。铜绿假单胞菌对环丙沙星、左氧氟沙星、美罗培南、亚胺培南、头孢呋辛酯、头孢唑林耐药率高达50%,其对头孢他啶、妥布霉素、庆大霉素、哌拉西林/他唑巴坦均敏感。结论 MDRO日益增多及其耐药性迅速提高,院感防控重点根据药敏结果合理选用抗菌药物同时重视环境卫生管理,落实每一病例防控、提高手卫生执行率,才能有效提高MDRO防控。
Objective To understand the distribution and drug resistance of multiple drug-resistant bacteria (MDRO) in our hospital. Methods A total of 3063 specimens of pathogenic microorganisms were collected from January to December in 2015. Samples including blood, body fluid, urine, stool, secretions, sputum and bronchoalveolar lavage fluid were sent to the laboratory of the People’s Hospital for examination in the bacteria room to cultivate. Results Fifty MDROs were analyzed by quantity and distribution. The top three were Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa, accounting for 60.0%, 12.0% and 8.0% respectively. The resistance rate of Escherichia coli to ampicillin was as high as 96.7%. The antibacterial activity of Escherichia coli against ampicillin, sulbactam, cefazolin, ciprofloxacin, levofloxacin, sulfamethoxazole tablets (trade name: Qusong resistance were more than 73%, to cefuroxime, cefoperazone / sulbactam, gentamicin resistance rates were> 40%. Its nitrofurantoin, amikacin, meropenem, imipenem, cefuroxime axetil are sensitive. Acinetobacter baumannii cefazolin and nitrofurantoin resistance rate of up to 60%, its cefuroxime, cefuroxime axetil, ampicillin resistance rate of 50%, its ceftazidime, ampicillin / sulbactam, cephalosporin Piperazone / sulbactam, aztreonam, gentamycin, tobramycin, ciprofloxacin, levofloxacin, meropenem, imipenem, cotrimoxazole, polymyxin B, piperacillin / Tazobactam are sensitive. Pseudomonas aeruginosa ciprofloxacin, levofloxacin, meropenem, imipenem, cefuroxime axetil, cefazolin resistance rate as high as 50% of ceftazidime, tobramycin, gentamicin, Piperacillin / tazobactam are sensitive. Conclusions MDRO is increasing and the drug resistance is rapidly increasing. The focus of prevention and control of nosocomial sensitivities should be based on the rational use of antimicrobial agents and pay attention to environmental health management. Implementation of prevention and control of each case and improvement of hand hygiene implementation rate can effectively improve the prevention and control of MDRO .