目的 了解我院通过加强合理应用抗菌药物管理后,多重耐药菌的构成比及变化趋势。方法 我院加强抗菌药物管理,引导医护人员掌握临床常用抗菌药物的应用范围和使用特点,根据患者的病情和体质及早使用敏感抗菌药。收集2010-01至2012-12我院检验科微生物实验室住院患者各类标本的多重耐药菌,检测分析。结果 检出的细菌菌株比例略呈下降趋势71.1%～59.3%,多重耐药菌(multi drug resistent organisms,MDRO)的构成比略呈下降趋势2.70%~2.35%,但无统计学意义(P>0.05),MDRO检出率显著降低0.19%～0.14%(P<0.05)。2010-01至2012-12,肺炎克雷伯菌、鲍曼不动杆菌、耐甲氧西林金黄色葡萄球菌(MRSA)和铜绿假单胞菌的检出率均由0.4‰降至0.3‰;大肠埃希菌检出率无变化,均为0.2‰。3年间鲍曼不动杆菌的构成比由23.0%降至19.1%,MRSA的构成比由23.7%降至20.4%。结论 合理选择抗菌药物可降低多重耐药菌的构成比。

Objective To investigate the application of optimal antimicrobial therapies to controlling the increase of multidrug-resistant organisms. Methods Hospital rational use of antimicrobial drugs by strengthening the basic application and characteristics of generally used antimicrobial agents, early use of sensitive drugs based on the patient’s condition and constitution were encouraged. From January 2010 to December 2012, multidrug-resistant organisms were analyzed from various types of specimens. Results From January 2010 to December 2012, the annual proportion of bacterial strains slightly turned down (71.1% vs.59.3%), multidrug resistent organisms (MDRO). MDRO decreased slightly (2.70% vs.2.35%), with no significant difference (P>0.05). Detection of MDRO was significantly reduced from 0.19% to 0.14% (P<0.05). From January 2010 to December 2012, the detection rate of Klebsiella pneumoniae, Acinetobacter baumannii, MRSA and Pseudomonas aeruginosa all reduced from 0.4‰ to 0.3‰, methicillin resistant Staphylococcus aureus(MRSA) from 0.4‰ to 0.3‰. The proportions of Acinetobacter baumannii and MRSA were reduced from 23.0% to 19.1%, and 23.7% to 20.4%, respectively. Conclusions Reasonable selection of antibiotics can control the increase of multidrug-resistant organisms.