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目的分析淄博地区多重耐药菌(multi-drug resistant organism,MDRO)的临床分布及耐药性,为地区性预防和控制MDRO的医院感染提供科学依据。方法回顾性分析淄博地区14家医院在2013年8月-2015年12月检出的2 570株多重耐药菌,采用法国梅里埃VITEK 2微生物鉴定和药敏系统对MDRO进行菌种鉴定和药敏检测。结果 2 570株多重耐药菌中,革兰阴性杆菌2 353株(91.56%),其中以产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌居首位(1 002株,38.99%),革兰阳性球菌(217株,8.44%)均为耐甲氧西林金黄色葡萄球菌(MRSA)。临床分离MDRO的科室主要为ICU(36.07%)和呼吸内科(10.58%)。耐碳青酶烯类的肠杆菌科细菌和鲍曼不动杆菌对临床常用抗菌药物的耐药率均在90%以上,尚未发现万古霉素耐药的金黄色葡萄球菌。结论淄博地区常见MDRO主要分离自收治重症和高龄患者的科室,需加强对高危科室和易感人群的监控并采取有效的感染控制措施,以遏制多重耐药菌的播散。
Objective To analyze the clinical distribution and drug resistance of multi-drug resistant organism (MDRO) in Zibo area and provide a scientific basis for regional prevention and control of MDRO. Methods A total of 2 570 multidrug-resistant strains were detected in 14 hospitals in Zibo area from August 2013 to December 2015. The MDRO strains were identified by using VITEK 2 Microbial Identification and Drug Sensitive System Sensitive detection. Results Among 2,570 multi-drug resistant strains, 2 353 (91.56%) were Gram-negative bacilli, of which Escherichia coli producing extended-spectrum β-lactamases (ESBLs) %), Gram-positive cocci (217, 8.44%) were methicillin-resistant Staphylococcus aureus (MRSA). Clinical departments of MDRO were mainly ICU (36.07%) and respiratory medicine (10.58%). Resistant to carbapenem-resistant enterobacteriaceae and Acinetobacter baumannii are more than 90% resistant to commonly used antimicrobial agents, and no vancomycin-resistant Staphylococcus aureus has yet been found. Conclusion The common MDROs in Zibo area are mainly separated from the departments of severe and elderly patients. The monitoring of high-risk departments and susceptible populations should be strengthened and effective infection control measures should be taken to prevent the spread of multi-resistant bacteria.