主要医院感染病原菌与社区感染株耐药性比较

目的比较主要医院感染(HAI)病原菌与社区感染(CAI)株的耐药性,指导合理使用抗菌药物。方法收集永康市第一人民医院2003年1月至2006年6月所有标本中分离的主要HAI菌及其CAI株,分别统计其药物敏感试验。采用美国Dade Behring Microscan Walkaway 40全自动细菌鉴定及药敏测试仪及其配套药敏鉴定板测定MIC值。全国医院感染监测网软件和χ2统计分析。结果主要HAI菌为前4种革兰阳性(G )菌依次是金黄色葡萄球菌、表皮葡萄球菌、屎肠球菌、溶血葡萄球菌,前5种革兰阴性(G-)菌依次是大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、阴沟肠杆菌。HAI株耐药率普遍高于CAI株,不同的细菌耐药率各具特点。不论HAI株还是CAI株,G 菌对万古霉素的耐药率最低,G-菌对亚胺培南的耐药率均较低,且两者耐药率差异均无显著性。金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌4种HAI株对大多数抗菌药物的耐药率明显高于CAI株,其余5种细菌HAI株仅对少数抗菌药物的耐药率高于CAI株。结论HAI菌株耐药性比CAI菌株强,临床应区分感染性质合理使用抗菌药物,有针对性控制感染,从而减少抗菌药物的滥用和细菌耐药性的产生。

Comparison of main bacterium drug-resistance in nosocomial infection and community infection

Objective To comparison of main bacterium drug resistance in nosocomial infection and community infection,and provide reference for the clinical reasonable application of antibiotics and infection control.Methods Bacteria isolated from patients in nosocomial infection and community infection,from Jan.2003 to Jun.2006 were evaluated by Microscanwalkaway 40.CHAI-square test was used.Results The main bacterium were made up of four Gram-position and five Gram-negitive strains.With highest number of four Gram-position strains were Staphylococcus aureus,Staphylococcus epidermiads,Enterococcus faecium,Staphylococcus haemolyticus,and five Gram-negitive strains were Escherichia coli,Klebsislla pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,Enterobacter cloacae,respectively.The main bacterium had higher resistance to most antibacterial in nosocomial infection than community infection.No matter in nosocomial infection or community infection,four Gram-position strains had the same lowest resistance to Vancomycin,and five Gram-negitive strains had the same lower resistance to Imipenem.Staphylococcus aureus,Escherichia coli,Klebsislla pneumoniae and Acinetobacter baumannii had higher resistance to most antibacterial in nosocomial infection than community infection.The other bacterium had higher resistance to few antibacterial in Nosocomial infection than community infection.Conclusion Most bacterium had higher resistance to most antibacterial in nosocomial infection than community infection.Clinician might distinguish the kind of infection and reasonable application of antibiotics to reduce the drug resistance.