Samet Alfred, Bronk Marek, Naumiuk Lukasz, Labon Marek, Sledzińiska Anna, Rybak Bartosz
Laboratorium Mikrobiologii Klinicznej Akademickiego, Centrum Medycyny Laboratoryjnej, Samodzielny Publiczny Szpital Kliniczny Nr 1 Akademii Medycznej w Gdańsku.
Przegl Epidemiol. 2005;59(4):881-90.
The aim of the study was to analyse the changes in occurence of microorganisms and antibiotic usage in tertiary care hospital over 3 years. We analysed the results of microbiological records from laboratory inforation systems from 2001 to 2003. Over the study period there was about 40% increase of specimens received in the laboratory mainly due to another hospital incorporation. The relations between different groups of microorganisms was stable, Gram negatives 44,4%-46,3%, Gram positives 37,3%-40,3%, yeasts 7,0%-8,1%. There was a decrease in MRSA from 0,6% to 0,2% and carbapenem resistant Pseudomonas aeruginosa (CRPA) isolations from 2,0% to 0,7%, however the reverse was true for VRE, increase from 0,3% to 2%. ESBL-producing bacteria were isolated from about 4% of Enterobacteriaceae throughout the study. The analysis of blood cultures revealed over 60% deacrease in P. aeruginosa bacteremia and stable incidence of Escherichia coli (7%) and Staphylococcus aureus (6,5%) bacteremia. Increased usage of cephalosporins and fluoroquinolones was accompanied by the decrease in carbapenems and penicillins. In most cases there were no significant changes in occurence of main groups of microorganisms. Some multidrug resistant bacteria like MRSA and CRPA are no longer a problem in our hospital. Others like VRE, ESBL and Acinetobacter still cause concern due to high colonisation or infection rate. The usage of some antibiotic groups increased, another decreased and finally some like aminoglicosides and glicopeptides remained stable.
该研究的目的是分析一家三级护理医院3年期间微生物的出现情况及抗生素使用的变化。我们分析了2001年至2003年实验室信息系统中的微生物记录结果。在研究期间,实验室接收的标本增加了约40%,主要是由于合并了另一家医院。不同微生物组之间的关系稳定,革兰氏阴性菌占44.4%-46.3%,革兰氏阳性菌占37.3%-40.3%,酵母菌占7.0%-8.1%。耐甲氧西林金黄色葡萄球菌(MRSA)从0.6%降至0.2%,耐碳青霉烯铜绿假单胞菌(CRPA)分离率从2.0%降至0.7%,然而耐万古霉素肠球菌(VRE)则相反,从0.3%增至2%。在整个研究过程中,约4%的肠杆菌科细菌分离出超广谱β-内酰胺酶(ESBL)产生菌。血培养分析显示,铜绿假单胞菌菌血症减少了60%以上,大肠杆菌(7%)和金黄色葡萄球菌(6.5%)菌血症的发病率保持稳定。头孢菌素和氟喹诺酮类药物使用增加,同时碳青霉烯类和青霉素类药物使用减少。在大多数情况下,主要微生物组的出现情况没有显著变化。一些多重耐药菌如MRSA和CRPA在我们医院已不再是问题。其他如VRE、ESBL和不动杆菌由于高定植或感染率仍令人担忧。一些抗生素组的使用增加,另一些减少,最后一些如氨基糖苷类和糖肽类保持稳定。