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目的 了解引起医院感染的细菌分布及耐药趋势 ,为临床治疗及医院感染的控制提供参考。方法 对本院2 0 0 0年 2月～ 2 0 0 1年 2月从医院感染患者标本中分离出的主要致病菌 ,采用 VITEK- AMS进行鉴定 ,按美国临床实验标准委员会 1999年判断标准用纸片扩散法进行敏感试验。结果 从细菌的分布来看 ,感染部位主要以下呼吸道为主 ,全年共分离病原菌 790株 ,革兰阳性菌 2 0 8株 ,其中甲氧西林耐药株 (MRS)分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的 4 0 %和 6 6 .2 %;革兰阴性菌 5 82株 ,主要以大肠埃希菌、不动杆菌、铜绿假单胞菌、克雷伯菌、嗜麦芽窄食单胞菌多见 ,其中产超广谱β-内酰胺酶的革兰阴性杆菌占 11.9%,在监测中未发现万古霉素耐药的金黄色葡萄球菌 ,但发现 1株耐万古霉素的肠球菌 ;革兰阴性杆菌对亚胺培南耐药率最低 ,对氨苄西林、哌拉西林、氟喹诺酮类耐药率较高。结论 医院感染的多重耐药问题相当严重 ,加强病原菌分布及耐药率监测 ,指导临床合理用药具有重大意义。
Objective To understand the bacterial distribution and drug-resistance trend of nosocomial infections and provide references for clinical treatment and nosocomial infection control. Methods The main pathogenic bacteria isolated from specimens of nosocomial infection from February 2000 to February 2001 in our hospital were identified by VITEK-AMS. According to the criteria of American Clinical Laboratory Standards Committee in 1999 Sensitivity test with disk diffusion method. Results From the distribution of bacteria, mainly the respiratory tract was the main site of infection, 790 strains of pathogenic bacteria and 208 strains of Gram-positive bacteria were isolated. Among them, methicillin-resistant strains (MRS) accounted for S. aureus and Coagulase-negative Staphylococcus aureus 40% and 66.2%; Gram-negative bacteria 5 82 strains, mainly in Escherichia coli, Acinetobacter, Pseudomonas aeruginosa, Klebsiella, Stenotrophomonas narrow The most common is Aeromonas, of which Gram-negative bacilli account for 11.9% of the total extended-spectrum β-lactamases. No vancomycin-resistant Staphylococcus aureus was detected during the surveillance but 1 vancomycin-resistant Enterococcus; Gram-negative bacilli the lowest rate of imipenem, ampicillin, piperacillin, fluoroquinolones resistance rate higher. Conclusion The multi-drug resistance problem of nosocomial infections is very serious. It is of great significance to strengthen the distribution of pathogens and monitor the drug resistance rate and guide clinical rational drug use.