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目的探讨多重耐药菌(MDRO)分布与变迁,为临床采取MDRO防控措施提供科学依据。方法回顾性分析某三甲妇女儿童专科医院新生儿科2012-2016年MDRO目标性监测结果,通过病历信息系统回查相关资料,对MDRO分布及变迁等情况进行分析与描述。结果共纳入本研究的MDRO 188株,分离自痰液、血液、气管导管残端、胃液、大便等。革兰阴性杆菌97株(51.60%),以产超广谱β-内酰胺酶(ESBL)菌为主;革兰阳性菌91株(48.40%),以耐甲氧西林凝固酶阴性葡萄球菌为主。肺炎克雷伯菌、表皮葡萄球菌、溶血性葡萄球菌检出情况总体呈下降趋势。社区获得感染与定植117株(62.23%),其中大肠埃希菌、肺炎克雷伯菌、表皮葡萄球菌呈下降趋势;医院获得感染与定植71株(37.77%),其中肺炎克雷伯菌、溶血性葡萄球菌及表皮葡萄球菌呈下降趋势,大肠埃希菌有上升趋势。MDRO的季度分布,除2012年以二季度较高外,其余均以三季度为高峰。结论新生儿科检出的MDRO以产超广谱β-内酰胺酶(ESBL)菌及耐甲氧西林凝固酶阴性葡萄球菌为主;院内获得的大肠埃希菌感染与定植有上升趋势;三季度可能为多重耐药菌检出的高峰。
Objective To investigate the distribution and changes of multidrug-resistant bacteria (MDRO) and provide a scientific basis for clinical prevention and control of MDRO. Methods A retrospective analysis was conducted on MDRO target surveillance results of Neonatology in a Grade III A woman and children’s hospital from 2012 to 2016. The related information was reviewed by the medical record information system to analyze and describe the distribution and changes of MDRO. Results A total of 188 MDR strains were included in this study and were isolated from sputum, blood, tracheal stumps, gastric juice, stools and so on. Ninety-seven Gram-negative bacilli (51.60%) were mainly ESBL-producing strains. Ninety-nine Gram-positive bacteria (48.40%) were gram-negative bacilli. The methicillin-resistant Staphylococcus aureus the Lord. Klebsiella pneumoniae, Staphylococcus epidermidis, the detection of hemolytic staphylococci generally showed a downward trend. Among them, Escherichia coli, Klebsiella pneumoniae and Staphylococcus epidermidis showed a decreasing trend; 71 strains (37.77%) were infected and colonized in the hospital, of which Klebsiella pneumoniae, Staphylococcus aureus and Staphylococcus epidermidis showed a downward trend, and Escherichia coli showed an upward trend. The quarterly distribution of MDRO, except for the second quarter of 2012, is higher than the third quarter. Conclusions The MDRO detected by the neonatology department mainly produces extended-spectrum β-lactamases (ESBL) and methicillin-resistant coagulase-negative staphylococci. Infection and colonization of Escherichia coli obtained in the hospital are on the rise. In the third quarter May be the peak of multiple drug-resistant bacteria.