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目的了解医院临床送检标本中病原菌的分布及70所医疗机构抗菌药物使用情况,制定控制感染对策。方法对2005-2009年临床标本分离菌进行调查统计分析;对70所专科医院、卫生院、诊所等医疗机构抗菌药物使用情况进行调查。结果 2005-2009年收集标本31 908份,分离出病原菌4972株,分离率为15.58%;革兰阳性球菌感染比例逐年下降,分别为51.8%、44.3%、34.6%、21.4%、15.9%;革兰阴性杆菌感染比例逐年增加,分别为42.2%、49.2%、58.6%、65.7%、68.7%;真菌感染逐年增加,分别为6.0%、6.5%、6.8%、12.9%、15.4%;产超广谱β-内酰胺酶的革兰阴性杆菌比例逐年增加,分别为21.0%、42.0%、55.0%、33.0%、35.0%,致使头孢类药物的耐药率增加。结论加强基层医院抗菌药物使用的规范管理,提高病原学送检率按药敏试验报告选择药物,能有效控制医院感染。
Objective To understand the distribution of pathogens in hospital clinical specimens and the use of antibacterials in 70 medical institutions to develop measures to control infection. Methods The clinical isolates from 2005 to 2009 were surveyed and statistically analyzed. Antibiotics use in 70 specialized hospitals, clinics and clinics was investigated. Results A total of 31 908 samples were collected from 2005 to 2009, 4972 strains of pathogens were isolated and the isolation rate was 15.58%. The proportion of Gram-positive cocci decreased year by year, which was 51.8%, 44.3%, 34.6%, 21.4% and 15.9% respectively. The proportion of infections with orchid-negative bacilli increased year by year, accounting for 42.2%, 49.2%, 58.6%, 65.7% and 68.7%, respectively. The fungal infections increased year by year with rates of 6.0%, 6.5%, 6.8%, 12.9% and 15.4% The proportion of β-lactamase-producing Gram-negative bacilli increased year by year, which was 21.0%, 42.0%, 55.0%, 33.0% and 35.0% respectively, which led to the increase of the resistant rate of cephalosporins. Conclusion Strengthen the standardized management of the use of antimicrobial drugs in primary hospitals and improve the rate of etiological examination. Select drugs according to drug susceptibility test report, which can effectively control nosocomial infections.