我院近年院内感染病原菌及耐药性分析

来源 :中华医学第九次全国检验医学学术会议暨中国医院协会临床检验管理专业委员会第六届全国临床检验实验室管理学术会议 | 被引量 : 0次 | 上传用户:fattingmore
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  目的:我室对2005年至2010年间院内感染菌群及分布和耐药情况进行了分析,总结了院内感染细菌分布及耐药情况,控制院内感染耐药性及超级细菌的发展。对指导临床合理使用抗生素,有着重要意义。
  方法:对密山市人民医院2005年临床分离菌株,常规培养,分离细菌。(1)药敏试验:采用Kirby-Bauer琼脂扩散法,按照《全国临床检验操作规程》进行,选用大肠埃希氏菌ATCC25922.铜绿假单胞菌ATCC27853、肺炎克雷伯菌ATCC700603、金黄色葡萄球菌ATCC25923做质控菌株。(2)产超广谱β-内酞胺酶(ESBLs)方法:头孢他啶、头孢他啶/克拉维酸,头孢噻肟、头孢噻肟/克拉维酸双纸片协同确证法。按2002年NCCLS标准判读。(3)耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林凝固酶阴性葡萄球菌〔MRCNS)检测方法:、头抱西丁纸片扩散法。(4)采用API软件与部分手工统计分析处理。
  结果:大肠埃希氏菌、金黄色葡萄球菌、铜绿假单胞菌、表皮葡萄球菌、阴沟肠杆菌、肺炎克雷伯菌为主要感染菌。感染标本主要来源于下呼吸道、伤口分泌物、各种插管、导管、尿液等。
  结论:肠杆菌科细菌对碳青酶烯类、头抱呱酮/舒巴坦高度敏感,最多见的菌种为:大肠埃希氏菌、肺炎克雷伯杆菌、阴沟肠杆菌,其中大肠埃希氏菌、肺炎克雷伯杆菌这两种菌株中所有产ESBLs株对所有青霉素类、头抱菌素类及氨曲南临床治疗显耐药性,肠杆菌肠杆菌科细菌对氟罗沙星高度耐药,大肠埃希氏菌对环丙沙星的耐药率高达60%,细菌的耐药状况应高度重视,合理使用抗生素避免耐药菌株产生是临床医师的当务之急。
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