摘要
目的探讨神经外科重症监护病房(NICU)多重耐药菌的分布特点、耐药情况,以及多重耐药菌感染的危险因素,以采取有效措施控制多重耐药菌医院感染的发生。方法采用回顾性调查方法,对2014年1月-12月在我院神经外科重症监护室出院患者的各类标本鉴定到的多重耐药菌的发生率、病原菌分布特征进行分析。结果 2014年我院NICU出院患者共1582人,住院总天数9395日。共分离出非重复菌株962株,主要为肺炎克雷伯菌(280株)、鲍曼不动杆菌(241株)、铜绿假单胞菌(148株)、金黄色葡萄球菌(122株,)和大肠埃希菌(98株)。其中产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌分别为80.5%和40.4%;碳青霉烯类耐药的鲍曼不动杆菌、肺炎克雷伯菌和大肠埃希菌分别为76.6%、28.3%和4.8%;金黄色葡萄球菌中MRSA阳性率为52.9%;多重耐药铜绿假单胞菌阳性率为21.62%;未检出耐万古霉素肠球菌(VRE)。结论 NICU多重耐药菌感染发生率高,特别是鲍曼不动杆菌、肺炎克雷伯菌检出率及耐药率较高。需从治疗、用药、护理等方面采取有效措施进行监督和指导,以预防和控制NICU病房中多重耐药菌引起的医院感染。
Objective To study the clinical distribution and drug resistance as well as risk factors of infection with multi-drug resistant（MDR） strains in neurosurgery ICU department（NICU）. Methods Multiple drug resistance and clinical distribution of MDR strains from January to December 2014 were studied retrospectively. Results A total of 962 strains of non-repeated strains were isolated from NICU patients,and they were mainly klebsiella pneumoniae（280 strains）,acinetobacter baumannii（241strains）,pseudomonas aeruginosa（148 strains）,staphylococcus aureus（122 strains） and E.coli（98 strains）. Among which the extended spectrum beta-lactamases（ESBLs） positive rates of E.coli and Klebsiella pneumonia were 80.5% and 40.4% respectively,and the Penicillium carbon alkene drug resistance of them were 4.8% and 28.3% respectively（76.6% for Acinetobacter baumannii as well）. The positive rate of MRSA in staphylococcus aureus was 52.9%. Pseudomonas aeruginosa showed multiple drug resistant,accounting for the rate of 21.62%,while the vancomycin resistant enterococcus（VRE） was not detected in drug sensitivity test.Conclusion The MDR rate in NICU was relatively high,especially for Acinetobacter baumannii and Klebsiella pneumoniae. Antibiotic resistance surveillance in NICU should be strengthened to guide rational antibiotic administration and hospital infection control.
出处
《实验与检验医学》
CAS
2015年第6期717-720,共4页
Experimental and Laboratory Medicine
基金
江西省教育厅科学技术研究项目(14020)
关键词
神经外科ICU
病原菌
多重耐药
Neurosurgery ICU
Pathogenic bacteria
Multiple drug resistance
