目的对我院消毒医疗用品及环境卫生学监测条件致病菌与临床分离病原菌耐药性进行同期对比调查,探讨其分布、耐药趋势及相关性。方法对卫生学监测阳性标本进行常规分离、鉴定细菌,选择条件致病菌采用M-H琼脂K-B扩散法检测其对抗菌药物的耐药性。药敏纸片根据安徽省细菌耐药性监控中心要求选择(NCCLS2004标准)。结果61份卫生学监测阳性标本中检出17种62株条件致病菌,总耐药率26.80%,以肠杆菌科耐药率最高39.47%。发现耐青霉素的葡萄球菌占68.42%,耐甲氧西林的葡萄球菌(MRS)占23.68%,主要分布在ICU和新生儿病区;耐万古霉素肠球菌(VRE)1株;产超广谱Β-内酰胺酶(ELBLs株)的肠杆菌科细菌占50%,多重耐药非发酵菌1株。同期临床标本分离病原菌26种135株,总耐药率45.30%,致病菌的耐药率以发酵菌为高,48.03%。结论医疗用品及环境监测条件致病菌较临床分离病原菌耐药性为低,但总体耐药趋势不容乐观,与临床菌谱有一定相关性。此项目耐药性监测为发现控制医院多重耐药菌株的定植扩散及临床合理使用抗菌药物等提供实验室依据,定期将监测结果向全院发布,提高全员对细菌耐药重要性的认识。 Objective To compare the drug-resistance of pathogenic bacteria isolated from medical supplies and environmental hygiene monitoring conditions in our hospital with those from clinical isolates, and to investigate their distribution, drug resistance trends and their correlations. Methods Hygienic positive samples were routinely isolated and bacteria were identified. M-H agar K-B diffusion assay was used to determine the resistance of the pathogens to antibacterials. Drug sensitive paper according to the requirements of Anhui Province Center for Bacterial Drug Resistance Monitoring (NCCLS2004 standard). Results Sixty-six strains of pathogenic bacteria were detected in 61 samples of hygiene surveillance. The total resistance rate was 26.80%, and the highest rate of Enterobacteriaceae was 39.47%. It was found that penicillin-resistant Staphylococcus aureus accounted for 68.42%, methicillin-resistant Staphylococcus aureus (MRS) accounted for 23.68%, mainly in ICU and neonatal ward; vancomycin-resistant enterococci (VRE) Enterobacteriaceae bacteria account for 50% of the beta-lactamase (ELBLs) strains and 1 is multi-resistant non-fermentative bacteria. In the same period clinical isolates of 26 pathogens were isolated from 135 clinical isolates, with a total resistance rate of 45.30%. The resistance rate of pathogens to fermentative bacteria was high at 48.03%. Conclusion The pathogenic bacteria in medical supplies and environmental monitoring conditions are lower than those in clinical isolates, but the trend of overall drug resistance is not optimistic and has some correlation with clinical spectrum. The monitoring of drug resistance in this project provided laboratory evidence for controlling the spread of multidrug-resistant strains in hospitals and the rational use of antimicrobial agents in hospitals. The monitoring results were regularly released to the whole hospital to raise awareness of the importance of bacterial resistance to the whole population.