绵阳市16家医院ICU 2013－2014年多重耐药菌临床分布特征及变化趋势-中国药房

绵阳市16家医院ICU 2013－2014年多重耐药菌临床分布特征及变化趋势

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篇名：	绵阳市16家医院ICU 2013－2014年多重耐药菌临床分布特征及变化趋势
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摘要：	目的：监测四川省绵阳市16家医院重症监护病房（ICU）多重耐药菌分布及变化趋势，为该地区控制多重耐药菌株暴发流行及经验性应用抗菌药物提供依据。方法：对各参与医院提供的2013年1月－2014年12月ICU临床分离的非重复性感染多重耐药菌进行数据筛选及汇总分析。结果：绵阳市16家医院ICU 2013－2014年共分离出病原菌3 578株，其中每年分离的前5位多重耐药菌种类均为鲍曼不动杆菌、产超广谱β-内酰胺酶（ESBLs）肺炎克雷伯菌、铜绿假单胞菌、产ESBLs大肠埃希菌和耐甲氧西林金黄色葡萄球菌（MRSA）。2013－2014年，鲍曼不动杆菌检出率由2.62％上升至3.31％（P＜0.05），对氨苄西林钠舒巴坦钠和复方磺胺甲噁唑的耐药率下降明显；产ESBLs肺炎克雷伯菌检出率由1.10％上升至1.69％（P＜0.05），对各类抗菌药物耐药率变化不大；铜绿假单胞菌检出率由2.81％下降至2.57％，对头孢菌素类和喹诺酮类耐药率有所下降；产ESBLs大肠埃希菌的检出率由7.93％上升至8.86％（P＜0.05），对各类抗菌药物耐药率变化不大；MRSA检出率由0.91％下降至0.81％，对青霉素类耐药率有所上升，对其他类别抗菌药物耐药率有不同程度下降。结论：绵阳市16家医院ICU 2013－2014年产ESBLs大肠埃希菌检出率较高，且鲍曼不动杆菌、产ESBLs肺炎克雷伯菌和产ESBLs大肠埃希菌感染总体呈上升趋势，对部分常用抗菌药物耐药率也呈上升趋势。多重耐药菌已成为医院感染的重要病原菌，各级医院ICU应加强监控，合理使用抗菌药物，遏制多重耐药菌株产生。
ABSTRACT：	OBJECTIVE： To monitor the distribution and tendency of multi-drug resistance bacterial in ICU of 16 hospitals from Mianyang city of Sichuan province， and to provide basis for controlling outbreaks and prevalence of multi-drug resistance bacterial and empirical use of antibacterial in this area. METHODS： According to isolated non-repetitive infection multi-drug resistance bacterial from ICU of involved hospital during Jan. 2013 to Dec. 2014， the data were screened and analyzed. RESULTS： A total of 3 578 strains were isolated from ICU of 16 hospitals in Mianyang city from 2013 to 2014. Top 5 multi-drug resistant bacterial were Bauman acinetobacter， ESBLs-producing Klebsiella pneumoniae， Pseudomonas aeruginosa， ESBLs-producing Escherichia coli and Methicillin-resistant Staphylococcus aureus （MRSA）. During 2013-2014， detection rate of B. acinetobacter increased from 2.62％ to 3.31％（P＜0.05）， and resistance rate of it to ampicillin sodium and sulbactam sodium and compound sulfapirazinmetossina decreased obviously； detection rate of ESBLs-producing K. pneumonia increased from 1.10％ to 1.69％（P＜0.05）， and resistance rate of it to various antibiotics changed slightly； detection rate of P. aeruginosa decreased from 2.81％ to 2.57％， and resistance rate of it to cephalosperin and quinolone decreased to certain extent； detection rate of ESBLs-producing E. coli increased from 7.93％ to 8.86％（P＜0.05）， and resistance rate of it to various antibiotics changed slightly； detection rate of MRSA decreased from 0.91％ to 0.81％， and resistance rate of it to penicillin increased to certain extent but to other antibiotics decreased at different levels. CONCLUSIONS： From 2013 to 2014， there was higher detection rate of ESBLs-producing E. coli in ICU of 16 Hospitals from Mianyang city. B. acinetobacter， ESBLs-producing K. pneumoniae and ESBLs-producing E. coli infection showed the overall upward trend. Resistance rate of 5 kinds of multi-drug resistant bacterial to part commonly used antibiotics shows upward trend. Multi-drug resistant bacterial has become an important pathogen of nosocomial infection， and the hospitals at all levels should be strengthened ICU monitoring， use antibiotic drugs rationally， and contain the production of multiple drug resistant strains.
期刊：	2016年第27卷第11期
作者：	贾超，蒋涵，李先全，陈宏，何海燕，陈宏碧
AUTHORS：	JIA Chao，JIANG Han，LI Xianquan，CHEN Hong，HE Haiyan，CHEN Hongbi
关键字：	重症监护病房；多重耐药菌；细菌耐药；绵阳市
KEYWORDS：	ICU； Multi-drug resistant bacterial； Drug resistance of bacterial； Mianyang city
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