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目的:了解病房空气含菌量和革兰阳性球菌、革兰阴性杆菌分离株的耐药情况,为医院感染治疗用药提供依据。方法:定点、定期、定人对病房空气消毒前后进行菌落计数、细菌分离、鉴定及药敏试验。结果:消毒后病房空气菌落数,明显低于清毒前,结果差异具有统计学意义(P<0.01)。2005年1月~2008年12月共送检2720份标本,检出革兰阳性球菌和革兰阴性杆菌582株,检出率为21.40%,以革兰阳性球菌居多(305株),其次为革兰阴性杆菌(257株);在逐年分离株对抗生素耐药率比较中,革兰阳性球菌对万古霉素、替考拉宁、喹奴普汀-达福普汀的耐药率无明显上升(P>0.05),对环丙沙星、利福平、克林霉素等抗生素耐药率上升明显(P<0.05);革兰阴性杆菌分离株对亚胺培南、美罗培南的耐药率无明显变化(P>0.05),其余抗生素的耐药率有上升趋势,其中对氨苄西林/舒巴坦、哌拉西林、头孢曲松、复方新诺明、头孢呋辛、环丙沙星耐药率呈明显上升(P<0.05);产酶株较非产酶株具有较高的耐药率。结论:通过消毒能有效杀灭大部分存活细菌,所以定期消毒显得十分必要。由于分离菌株对抗生素的耐药率有明显上升趋势,建议临床医师根据实验室药敏结果,合理使用抗生素。
Objective: To understand the bacteriological airborne bacteria and Gram-positive cocci, Gram-negative bacilli isolates resistant situation, provide the basis for the treatment of nosocomial infections. Methods: Fixed-point, regular, scheduled for air disinfection of the ward before and after the colony count, bacterial isolation, identification and susceptibility testing. Results: The number of airborne bacteria in ward after disinfection was significantly lower than that before disinfection, the difference was statistically significant (P <0.01). From January 2005 to December 2008 a total of 2720 specimens were sent for inspection, and 582 Gram-positive cocci and Gram-negative bacilli were detected, the detection rate was 21.40%, of which were Gram-positive cocci (305 strains), followed by Gram-negative bacilli (257 strains). In the year-by-year isolates, there was no significant resistance rate of gram-positive cocci to vancomycin, teicoplanin, quinudin-dalfopristin (P> 0.05). The rates of antibiotic resistance to ciprofloxacin, rifampicin and clindamycin increased significantly (P <0.05). Gram-negative bacilli isolates were resistant to imipenem and meropenem There were no significant changes in the drug rates (P> 0.05), and the antibiotic resistance rates of the remaining antibiotics showed an upward trend. Among them, ampicillin / sulbactam, piperacillin, ceftriaxone, cotrimoxazole, cefuroxime, Star resistance rate was significantly increased (P <0.05); enzyme-producing strains than non-producing strains have a higher resistance rate. Conclusion: Sterilization can effectively kill most of the surviving bacteria, so it is necessary to disinfect regularly. As isolates strains of antibiotics resistance rates increased significantly, it is recommended that clinicians based on laboratory susceptibility results, the rational use of antibiotics.