佛山市院內(nèi)感染的監(jiān)測及其致病菌的耐藥性研究

[摘要] 目的 了解及分析本院以及本市臨床細(xì)菌及真菌院內(nèi)感染的特點(diǎn)及耐藥狀況，為臨床提供合理使用抗生素的建議及指引，以達(dá)到減少院內(nèi)感染和控制耐藥率上升的目的。方法 采用VITEK-AMS全自動(dòng)微生物分析儀與手工K-B法相結(jié)合的方法，對本院2006年1～12月臨床各類送檢標(biāo)本進(jìn)行分離培養(yǎng)并檢測其對多種抗生素的耐藥性;采用WHONET5軟件，從送檢科室、標(biāo)本類別、分離菌種及其對抗生素的耐藥性等方面進(jìn)行統(tǒng)計(jì)和分析，得出一系列有建設(shè)性的研究數(shù)據(jù)。結(jié)果 共檢測標(biāo)本13391例，陽性3758例，陽性檢出率28.1%，院內(nèi)感染以大腸埃希菌、銅綠假單胞菌、金黃色葡萄球菌、肺炎克雷伯菌最常見;真菌亦有6.01%的檢出率;院內(nèi)感染主要以呼吸道、泌尿道及外科感染為主;所有檢出的菌株對臨床各種常用抗生素均呈不同程度的耐藥性，且其多重耐藥呈增加趨勢。結(jié)論 開展院內(nèi)感染及其致病菌耐藥性監(jiān)測，對于合理用藥、提高療效、減緩細(xì)菌耐藥率以及控制院內(nèi)感染均有重要意義。

[關(guān)鍵詞] 院內(nèi)感染;致病菌;抗生素;耐藥性

[中圖分類號(hào)] R197[文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1673-9701(2010)04-08-04

Hospital Acquired Infection Surveillance and Drug Resistance of Pathogenic Bacteria in Foshan

MA Junbao1CHEN Zichi2CHEN Hanbin3CHEN Kaiting4LIANG Mingxuan5

1. Department of Clinical Laboratory，F(xiàn)oshan Municipal First People’s Hospital，F(xiàn)oshan 528000，China;2. Department of Clinical Laboratory，F(xiàn)oshan Municipal Nanhai District Danzao Hospital，F(xiàn)oshan 528216，China;3. Department of Clinical Laboratory，F(xiàn)oshan Municipal Nanhai District Maternal and Child Healthcare Hospital，F(xiàn)oshan 528200，China;4. Department of Clinical Laboratory，F(xiàn)oshan Municipal Third People’s Hospital，F(xiàn)oshan 528000，China;5. Department of Clinical Laboratory，F(xiàn)oshan Municipal Luocun Hospital，F(xiàn)oshan 528000，China

[Abstract] Objective To analyze the hospital acquired infection(HAI) and drug resistance of pathogenic bacteria in our hospital and the hospitals of Foshan city in an attempt to provide reasonable use of antibiotics for clinical recommendations and guidelines to achieve the reduction of HAI and control of increasing drug resistance rate. Methods All the bacteria samples were collected from our hospital and the hospitals of Foshan city during Jan. 2006 to Dec. 2006. The samples were isolated，cultured and detected by VITEK-AMS automicrobiology system and manual K-B methods. And then the WHONET-5 software was used for statistics analysis of those data including submission sections，specimen type，separating bacteria and their resistance to antibioticsin order to draw a series of constructive data. Results From all 13391samples，3758 samples were positive，with the positive rate of 28.1%，andthe first five pathogenic bacteria of HAI were E.cole，P.aeruginose，S.aureus，K.pneumoniae and fungus(6.01%). HAI showed mainly in the respiratory tract，mainly urinary tract and surgical infections. All the strains detected showed varying degrees of drug resistance to commonly used drugs. Conclusion The surveillance of both HAI and pathogens is of great importance in rational drug use，improvement of curative efficacy，decrease in the rate of bacterial resistance and control of HAI.

[Key words] Hospital acquired infection;Pathogenic bacteria;Antibiotic;Drug resistance

近年來，由于廣譜抗生素在臨床上的廣泛使用尤其是濫用，導(dǎo)致醫(yī)院感染微生物的種類與數(shù)量迅速增加，其耐藥率也隨之迅速飚升，目前，院內(nèi)感染己成為臨床醫(yī)療界抗感染治療的最棘手問題之一。

為了盡快了解并掌握本市各種微生物感染及其耐藥狀況，指導(dǎo)臨床合理使用抗生素，有效遏止耐藥菌的產(chǎn)生及其耐藥率的上升、控制其播散、流行以及院內(nèi)感染的發(fā)生，筆者對作為本地區(qū)最具代表性的最大型的綜合性三甲醫(yī)院-佛山市第一醫(yī)院及數(shù)家基層醫(yī)院2006年臨床微生物的院內(nèi)感染及其耐藥狀況進(jìn)行了數(shù)據(jù)統(tǒng)計(jì)與綜合分析。……