神经内科医院感染患者的病原菌谱及耐药性研究  

Clinical Characterization,Spectrum of Pathogens and Drug Resistance of Patients with Nosocomial Infection in Neurological Departments

作　　者：许亚茹[1] 郑秀芬[2] 元小冬[2] 袁宝军[3] 张树春[3] 

机构地区：[1]华北煤炭医学院附属医院医院感染管理科,河北唐山063000 [2]华北煤炭医学院附属开滦医院神经内科,河北唐山063000 [3]华北煤炭医学院附属开滦医院,河北唐山063000

出　　处：《中华医院感染学杂志》2010年第3期427-429,共3页Chinese Journal of Nosocomiology

基　　金：唐山市临床医学研究计划基金项目(08130214c)

摘　　要：目的研究神经内科医院感染患者的病原菌分布和耐药性,为预防控制医院感染和抗菌药物的应用提供依据。方法对医院神经内科病区1427例住院患者中发生医院感染的病例进行研究,按规范采集相应的痰、血、尿等标本进行病原学培养及药敏试验。结果医院感染发病率6.73%,医院感染部位中,下呼吸道58.00%、上呼吸道21.00%、泌尿道9.00%,病原学检查真菌和G-杆菌高于G+球菌(44.73%、42.11%、13.16%,P=0.003);真菌对酮康唑和氟康唑的敏感性强,而G-杆菌和G+球菌均对左氧氟沙星和头孢噻肟敏感性高。结论神经内科医院感染部位以下呼吸道最常见,病原菌以真菌最多见,其次为G-杆菌,真菌性感染治疗首选酮康唑,而细菌性感染则首选头孢噻肟、左氧氟沙星等药物。OBJECTIVE To study the clinical characteristics, distributions and antibiotic resistance of pathogens in the patients with nosocomial infection（NI）, and provide the theoretical basis for NI prevention and application of antibiotics in neurological departments. METHODS All of the cases with NI were studied in the neurological departments （1427 inpatients）. Samples of sputum, blood and urine were collected according to the criterion, then identified and tested of drug sensitivity. RESULTS The incidence of NI was 6. 73%; the frequent NI sites in neurological departments were as follows： lower respiratory tract （58. 00%）, upper respiratory tract （21.00%） and urinary tract （9.00%）. The rate of fungi and G- bacilli were more than that of G＋ cocci（44.73%, 42.11% and 13.16%,P= 0. 003）. Fungi were sensitive to ketoconazole and fluconazole. G bacilli and G＋ cocci were sensitive to levofloxaoin and cefotaxime. CONCLUSIONS The most frequent NI site in neurological departments is lower respiratory tract. The most frequent pathogens are fungi, followed by G- bacilli. Ketoconazole is the first choise for fungus infections and cefotaximefor and levofloxacin for bacterial infections.

关 键 词：神经内科 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]