| BackgroundIn recent years, with media reports of multi-resistant bacteria growing, "superbugs" increasingly cause the attention of the medical staff[1]. China MRSA (methicillin-resistant staphylococcus aureus) monitoring rate of 50%, ranking among the top in the world. ESBL (produce ultra broad spectrum beta lactamase coli), CRE (resistance to carbon black enzyme and type of pneumonia klebsiella bacteria), MDRAB (pan, the resistant acinetobacter baumannii) such as detection rate were higher in comprehensive hospital. MRSA infection almost all over the world, become one of the most common pathogen in clinical, with HIV/AIDS, hepatitis b is called the world three big infection disease.All kinds of antimicrobial agents, especially the wide use of broad-spectrum antimicrobial agents, clinical bacteria resistant form is serious, has become a medical problem of concern at home and abroad. China issued by the administrative department of public health of multi-resistant bacteria in hospital infection control work notice [who do medical hair (2008) 2008] and the more resistant bacteria in hospital infection prevention and control technology guidelines (try out) "[who d do hair (2011) 5, a number of documents, such as to strengthen the hospital infection management of multi-resistant bacteria, effectively prevent and control the spread of multi-resistant bacteria, to ensure the safety of medical treatment, in order to make the medical staff to better understand the hospital the susceptible factors of multi-resistant bacteria and drug resistance trend, reasonable treatment, and prevention and control measures as early as possible, improve the level of diagnosis and treatment of medical institutions and hospital infection prevention and control of, for the following research.ObjectivesTo explore multiple drug-resistant bacteria susceptible factors and drug-resistant bacteria trend, provide the basis for empirical treatment in all the subjects. According to speculation that multiple drug-resistant bacteria infection of susceptible factors as important basis for monitoring the various types of multi-resistant bacteria resistance, can provide the basis for clinical doctors empirical treatment, by comparing 2013 and 2013, resistance to change, can be indirectly evaluate the efficacy of the related management measures multi-resistant bacteria.MethodsRetrospective investigation from 2013 to 2014 of the third people’s hospital of bengbu detection of multiple drug-resistant bacteria, and on the basis of the data, sample source, such as bacterial susceptibility test results were analyzed. Based on monitoring results, the department of multi-resistant bacteria distribution and drug resistance trend change. At the same time, compared with 2014 in 2013 kinds of multi-resistant bacteria resistant trend analysis.Main ResultsDevelop department multi-resistant bacteria distribution and drug resistance trend variation. Can obviously multi-resistant bacteria distribution in ICU, orthopedics, general surgery department is given priority to, such as susceptible factors mainly include age, invasive operation, etc. MRSA resistant rate in more than 40% of erythromycin, clindamycin, levofloxacin, tetracycline, rifampicin, gentamicin; Under 40% of the percentages of vancomycin, their stead ning, and compound new Ming. In the clinical treatment of suspected staphylococcus aureus infection should be reference. ESBL e. coli resistant rate in more than 40% of gentamicin ciprofloxacin, and compound new Ming and; Under 40% of the percentages of cefoxitin, piperacillin/he thiazole ba jotham, beauty e.faecalis and imide south, amikacin; Among them, the cefoxitin resistant rate between 30% and 40%. ESBL e. coli higher detection rate of general surgery department, should be in the use of antibacterial drug prevention and treatment for reference.ESBL pneumonia klebsiella bacteria resistant rate to produce ESBL e. coli, slightly lower prevalence of resistance to various antibiotics. CRE pneumonia klebsiella bacteria (clinical detection of cases is growing rapidly, although the proportion is not high, but because of the possible KPC enzyme production, for such close attention must be paid to the bacteria, prevent more CRE cases. MDRAB for a variety of common clinical antibacterial drug resistant rate are high, belongs to the generic drug resistant acinetobacter baumannii, its composition in total multi-resistant bacteria is higher, should be cause for concern.For patients in ICU, age and samples as well as chronic inflammation, the choice of antimicrobial agents can be used as multiple drug-resistant bacteria infection of forecast factors and standards. According to the different department admitted patients, clinicians can according to the characteristics of the patients considering infection made relevant prediction.As control hospital infection management departments, should be more strict detection department, and strengthen the contact with microbiology laboratory, infection outbreak alert awareness, at the same time to strengthen a few check out more clinical departments to establish the key link, for evaluation of the bacterial infection suggest antibacterial drugs clinical effect.Conclusions and suggestionsMultiple drug-resistant bacteria detection rate increased significantly, the department has the distribution, clinical patients can be combined with the primary disease and related risk factors makes predictions of multi-resistant bacteria infection, so as to timely reasonable choose sensitive antimicrobial agents. Multiple drug-resistant bacteria infection is more, it is not only confined to the hospital, more long-term extensive use of antimicrobial agents in patients with chronic inflammation after treatment susceptible to bacterial drug resistance, lead to multiple drug-resistant bacteria, the control of multi-resistant bacteria should be as a public health event to intervene, into the related key disease research, control the abuse of antibiotics from the each link, high-risk department to colonize work in hospital, so as to effectively curb the multi-resistant bacteria. |
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