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目的掌握某院2012—2015年儿科非发酵革兰阴性杆菌的分布和耐药性及其变迁的动态趋势,对指导儿科医师合理选用抗菌药物,为控制耐药菌的产生和预防控制院内感染提供理论依据。方法收集2012年1月至2015年12月间微生物室所接收的某院儿科病区送检的各类标本,对其进行分离培养鉴定,应用WHONET软件和SPSS 17.0统计软件对菌株和药敏数据进行统计分析。结果某院非发酵革兰阴性杆菌在各类临床标本中,以痰液的检出率(69.98%,1 520/2 172)最高。检出非发酵细菌以鲍曼不动杆菌最多,其次为铜绿假单胞菌、嗜麦芽窄食单胞菌,共占85.49%。鲍曼不动杆菌对阿米卡星、哌拉西林/他唑巴坦和头孢他啶的耐药率<25%,但呈上升趋势(P<0.01);铜绿假单胞菌对8种抗菌药物的耐药率均<25%;嗜麦芽窄食单胞菌对头孢哌酮/舒巴坦的耐药率>35%。4年间鲍曼不动杆菌耐药趋势变化较大。结论某院儿科非发酵革兰阴性杆菌耐药现象严重,对各种临床常用抗菌药物均耐药,其中鲍曼不动杆菌耐药率多呈上升趋势。控制耐药菌的产生与传播,不仅临床医生要加强抗菌药物的合理使用,而且必须重视院内感染各项防控措施的落实。
OBJECTIVE To grasp the dynamic trends of the distribution and drug resistance of pediatric non-fermentative gram-negative bacilli in a hospital from 2012 to 2015 and to guide pediatricians in the rational selection of antimicrobial agents for the control of drug-resistant bacteria and prevention and control of nosocomial infections Theoretical basis. Methods The specimens collected from the pediatric ward of a hospital received from the Department of Microbiology between January 2012 and December 2015 were collected and identified for their isolation and culture. The WHONET software and SPSS 17.0 statistical software were used to analyze the strains and susceptibility data conduct statistical analysis. Results The non-fermentative gram-negative bacilli in a hospital were the highest in all kinds of clinical specimens with the detection rate of sputum (69.98%, 1 520/2 172). Acinetobacter baumannii was detected most frequently in non-fermentative bacteria, followed by Pseudomonas aeruginosa and Stenotrophomonas maltophilia, accounting for 85.49%. Acinetobacter Bauman resistance rates to amikacin, piperacillin / tazobactam and ceftazidime <25%, but an upward trend (P <0.01); Pseudomonas aeruginosa 8 antibacterial drugs Resistant rate was <25%; Stenotrophomonas maltophilia resistant to cefoperazone / sulbactam> 35%. 4 years Acinetobacter baumannii drug resistance trends change. Conclusions The pediatric non-fermentative gram-negative bacilli are highly resistant to various antibiotics commonly used in clinical practice. Among them, the rate of Acinetobacter baumannii is on the rise. Control of the emergence and spread of drug-resistant bacteria, not only clinicians to strengthen the rational use of anti-bacterial drugs, and must pay attention to the implementation of various prevention and control measures of nosocomial infections.