肝移植受体医院感染病原菌分布及其耐药性分析  

Distribution and Drug Resistance of Pathogenic Bacteria of Nosocomial Infection in Liver Transplantation Recipients

作　　者：杨慧宁[1] 王鲜平[1] 曹力[1] 吕晓丽[1] 刘元明[1] 

机构地区：[1]中国人民武装警察部队总医院,北京市100039

出　　处：《职业与健康》2010年第23期2799-2802,共4页Occupation and Health

摘　　要：目的探讨肝移植受体医院感染的病原菌分布及其耐药性。方法对武警总医院2007年1月—2008年1月期间142例肝移植受体发生医院感染送检的各类标本中分离出的731株病原菌的分布及耐药性进行回顾性调查。结果肝移植患者术后感染发生率为42.96%。病原菌以革兰阴性杆菌为主,占44.46%。主要菌株为铜绿假单胞菌15.05%,不动杆菌13.41%,嗜麦芽窄食单胞菌8.48%,大肠埃希菌3.00%,肺炎克雷伯菌1.78%;其次为革兰阳性球菌,占35.71%;主要为屎肠球菌12.86%,凝固酶阴性葡萄球菌8.07%,金黄色葡萄球菌4.79%,粪肠球菌4.38%,鸟肠球菌3.15%。真菌占比例最少,共145株,占19.84%;主要以白色念珠菌为主,占6.57%;其次是曲霉菌4.79%。病原菌分离部位以痰、胆汁、切口分泌物为主,占78.11%。常见菌种基本上都呈多重耐药,细菌耐药现象严重,但革兰阴性杆菌对头孢哌酮—舒巴坦、头孢他啶耐药率相对较低,没有发现耐万古霉素的葡萄球菌。结论加强肝移植受体术后的细菌分离及耐药性监测,对于合理使用抗生素预防和治疗院内感染十分重要。[Objective] To study the distribution and drug resistance of pathogenic bacteria of nosocomial infection in liver transplantation recipients.[Methods]The pathogenic bacteria distribution and drug resistance of 731 trains of pathogenic bacteria which isolated from the nosocomial infection samples of liver transplantation recipients in the General Hospital of Chinese People＇s Armed Police Forces from January 2007 to January 2008 were investigated retrospectively.[Results]The incidence of postoperative infection among liver transplantation patients was 42.96%. The pathogenic bacteria was dominated by Gram-negative bacilli, which accounted for 44.46%, the main strains included Pseudomonas aeruginosa （15.05%）, Acinetobacter （13.41%）, Stenotrophomonas maltophilia （8.48%）, escherichia coli （3.00%） and Klebsiella pneumoniae （1.78%）. The Gram-positive bacteria accounted for 35.71%, including feces Enterococcus （12.86%）, Coagulasenegative staphylococcus （8.07%）, Staphylococcus aureus （4.79%）, Enterococcus faecalis （4.38%） and Enterococcus avium （3.15%）. There were 145 strains of fungi, which accounted for 19.84%, including Candida albicans （6.57%） and aspergillus （4.79%）. 78.11% of pathogenic bacteria were isolated from phlegm, bile and wound secretion. The common bacteria had multidrug resistance basically, and bacterial resistance was serious. The resistance rates of Gram-negative bacteria to cefoperazone-sulbactam and ceftazidime were relatively low, and no vancomycin-resistant Staphylococcus aureus was found.[Conclusion]It is very important to strengthen the bacterial isolation and surveillance of drug resistance in liver transplantation recipients after operation, so as to improve the rational use of antibiotics and prevent the nosocomial infection.

关 键 词：病原菌 肝移植 耐药性 流行病学 

分 类 号：R181[医药卫生—流行病学]