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目的探讨临床微生物检验和细菌耐药性监测情况。方法回顾性选取2015年7月至2016年7月沈阳市红十字会医院重点科室的生物标本涉及的非重复分离菌株193株,综合分析其检验情况及细菌耐药性,并评估其微生物标本检验、细菌药敏试验结果。结果 (1)本组193株致病菌中,耐药菌株占19.2%。其中ICU的耐药菌株所占比例最高,为25.7%;其次是外科,耐药菌株占22.8%;儿科耐药菌株占12.9%;内科耐药菌株占12.5%。(2)革兰阳性菌共120株,占62.2%;革兰阴性菌共73株,占37.8%;其中凝固酶阴性葡萄球菌所占比例最高,为33.7%,其次是金黄色葡萄球菌,占16.1%,再次是铜绿假单胞菌,占10.4%;其余菌株所占比例均相对较低,其中大肠埃希菌占8.8%,不动杆菌属占7.7%,克雷伯菌属占6.2%,枸缘酸菌属占4.7%,肠杆菌属占4.7%,变形杆菌属占3.1%,肠球菌占2.6%,其他菌种占2.1%。结论对医院内抗菌药物实施规范化管理的前提下,还需不断提升检验人员的微生物检验、细菌耐药性检测中的操作技能水平,从而逐步完善医院临床微生物实验室,提升整体质量管理水准。
Objective To investigate clinical microbiological tests and bacterial drug resistance monitoring. Methods A retrospective analysis of 193 non-repetitive isolates from the biological samples of key departments of Shenyang Red Cross Hospital from July 2015 to July 2016 was conducted. The test results and bacterial resistance were analyzed comprehensively and their microbiological tests , Bacterial susceptibility test results. Results (1) Among the 193 pathogenic bacteria in this group, the resistant strains accounted for 19.2%. Among them, the drug-resistant strains of ICU accounted for the highest proportion, accounting for 25.7%; followed by surgical, drug-resistant strains accounting for 22.8%; pediatric drug-resistant strains accounting for 12.9%; (2) There were 120 strains of Gram-positive bacteria, accounting for 62.2%; 73 strains of Gram-negative bacteria, accounting for 37.8%; coagulase-negative staphylococci accounted for the highest proportion (33.7%), followed by Staphylococcus aureus 16.1%, again Pseudomonas aeruginosa, accounting for 10.4%; the proportion of other strains were relatively low, of which Escherichia coli accounted for 8.8%, Acinetobacter accounted for 7.7%, Klebsiella accounted for 6.2% , Accounting for 4.7% of the genus Corynebacterium, 4.7% of Enterobacter, 3.1% of Proteus, 2.6% of enterococci and 2.1% of other species. Conclusion On the premise of standardized management of antimicrobial drugs in hospitals, it is necessary to continuously improve the level of operation skills in the examination of microorganisms and bacterial resistance in order to gradually improve the clinical microbiology laboratory in hospitals and improve the overall quality management standards.