目的 分析我院常见多重耐药菌(multiple drug resistant organism，MDRO)分布特点及耐药性，为临床合理用药和MDRO防控提供参考。方法 对我院2020年1月—2022年12月临床分离MDRO的标本来源、科室分布及耐药情况进行分析。结果 2020年1月—2022年12月共分离MDRO 436株，其中耐甲氧西林金黄色葡萄球菌(MRSA)检出率最高，占34。86％;其次为耐碳青霉烯类鲍曼不动杆菌(CR-AB)及产超广谱β-内酰胺酶大肠埃希菌(ESBL-Eco)，分别占27。75％、20。41％;产超广谱β-内酰胺酶肺炎克雷伯菌(ESBL-Kpn)、多重耐药铜绿假单胞菌(MDR-PA)较低，分别占9。41％、7。57％，未检出耐万古霉素肠球菌(VRE)和耐碳青霉烯类肠杆菌科细菌(CRE)。标本主要来源于痰液，其次为创面分泌物和尿液。科室主要分布在烧伤科、呼吸内科、重症医学科及神经科。MRSA对米诺环素、利奈唑胺、替考拉宁、万古霉素、复方新诺明100％敏感，对青霉素类、氟喹诺酮类、大环内酯类抗菌药物耐药率均在80。00％以上;除替加环素、米诺环素外，CR-AB对其他抗菌药物的耐药率均在75。00％以上;MDR-PA对亚胺培南、美罗培南耐药率均达到72。73％;ESBL-Eco及ESBL-Kpn对青霉素类、头孢菌素类(除头孢吡肟)、氟喹诺酮类等抗菌药物耐药率高。结论 医院应加强MDRO监管，采取有效防控措施，防止MDRO产生与传播。
Distribution characteristics and drug resistance of common multiple drug resistant bacteria in clinic
Objective To analyze the distribution characteristics and drug resistance of multiple drug resistant organism(MDRO)in our hospital,and to provide reference for clinical rational drug use and MDRO prevention and control.Methods The source,distribution and drug resistance of MDRO samples clinically isolated from January 2020 to December 2022 in our hospital were analyzed.Results From January 2020 to December 2022,a total of 436 strains of MDRO were isolated,the detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was the highest at 34.86％,followed by carbapenem-resistant Acinetobacter baumannii(CR-AB)and extended-spectrum β-lactamase-producing Escherichia coli(ESBL-Eco),respectively accounted for 27.75％and 20.41％.Extended-spectrum β-lactamase-producing Klebsiella pneumoniae(ESBL-Kpn),multidrug-resistant Pseudomonas aeruginosa(MDR-PA)were relatively low,respectively accounted for 9.41％and 7.57％,and no vancomycin-resistant Enterococci(VRE)and carbapenem-resistant Enterobacteriaceae(CRE)were detected.The samples mainly came from sputum,followed by secretions and urine.The departments were mainly distributed in the department of burns,respiratory medicine,critical care medicine and neurology.MRSA was 100％sensitive to minocycline,linezolid,teicoplanin,vancomycin,co-trimoxazole,and the resistance rates to penicillins,fluoroquinolones,macrolides and other antibiotics were all above 80.00％.Except for tigecycline and minocycline,the resistance rate of CR-AB to other antibacterial drugs was above 75.00％,the resistance rate of MDR-PA to imipenem and meropenem reached 72.73％,ESBL-Eco and ESBL-Kpn had a high resistance rate to penicillins,cephalosporins(except cefepime),fluoroquinolones and other antibiotics.Conclusion The hospitals should strengthen the supervision of MDRO and take effective prevention and control measures to prevent the generation and spread of MDRO.
Multiple drug resistantInfectionDistributionDrug resistance
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