论文部分内容阅读
目的了解2012-2014年急诊科重症患者院内感染病原菌分布及耐药情况,为控制感染发生及耐药性发展提供指导。方法收集2012-2014年急诊科重症患者送检样本,分离菌株,采用全自动细菌鉴定仪进行菌种鉴定,K-B法进行药敏试验。结果 2012年1月~2014年12月住院的941例急诊重症患者的各类临床标本共分离出病原菌545株,其中革兰阴性菌331株(占60.73%),革兰阳性菌181株(占33.21%),真菌11株(占2.02%)。革兰阴性菌主要为铜绿假单胞菌(331株),肺炎克雷伯菌(103株),鲍曼不动杆菌(51株)以及大肠埃希菌(43株);革兰阳性菌主要为金黄色葡萄球菌(83株),凝固酶阴性葡萄球菌(53株)和粪肠球菌(45株);真菌较少,主要为白色假丝酵母菌(20株)。2012-2014年铜绿假单胞菌对环丙沙星的耐药率分别为57.45%、50.00%和60.98%,肺炎克雷伯菌、鲍曼不动杆菌和大肠埃希菌对亚胺培南耐药率最低,且4种革兰阴性菌耐药性逐年增加。2012-2014年金黄色葡萄球菌、凝固酶阴性葡萄球菌和粪肠球菌对青霉素耐药率最高,对万古霉素耐药率最低,且各分离菌耐药性逐年增加。结论 2012-2014年急诊科重症患者院内感染以革兰阴性菌为主,且各分离菌耐药性逐年增高,加强病原菌药敏试验监测对医院感染的预防和治疗具有重要意义。
Objective To understand the distribution and drug resistance of nosocomial infection pathogens in emergency department during emergency department from 2012 to 2014 and provide guidance for controlling the occurrence of infection and development of drug resistance. Methods The samples collected from patients with emergency department of emergency department between 2012 and 2014 were collected and the isolates were isolated. The strains were identified by automatic bacteria analyzer and K-B method. Results A total of 545 pathogens were isolated from 941 emergency critically ill patients hospitalized from January 2012 to December 2014. Among them, 331 (60.73%) were Gram-negative bacteria, and 181 (0.9%) were Gram-positive bacteria 33.21%), 11 fungi (2.02%). Gram-negative bacteria mainly Pseudomonas aeruginosa (331 strains), Klebsiella pneumoniae (103 strains), Acinetobacter baumannii (51 strains) and Escherichia coli (43 strains); Gram-positive bacteria mainly Staphylococcus aureus (83 strains), coagulase-negative Staphylococcus (53 strains) and Enterococcus faecalis (45 strains); fungi less, mainly Candida albicans (20 strains). The resistance rates of Pseudomonas aeruginosa to ciprofloxacin from 2012 to 2014 were 57.45%, 50.00% and 60.98%, respectively. Klebsiella pneumoniae, Acinetobacter baumannii and Escherichia coli were resistant to imipenem The lowest rate of resistance, and four kinds of Gram-negative bacteria increased year by year. Staphylococcus aureus, coagulase-negative Staphylococcus aureus and Enterococcus faecalis were the most resistant to penicillin and the lowest to vancomycin between 2012 and 2014. The drug resistance of each isolates increased year by year. CONCLUSIONS: Gram-negative bacteria are the most common nosocomial infections in emergency department of emergency department between 2012 and 2014, and the drug resistance of each isolates is increasing year by year. It is of great significance to strengthen the drug susceptibility testing of pathogenic bacteria in the prevention and treatment of nosocomial infections.