心血管病医院小儿外科术后感染病原菌的耐药分析  

Pathogens and Their Drug-resistance in Pediatrics Patients after Surgery in Cardiovascular Hospital

作　　者：程军[1] 金智红[1] 王飞燕[1] 

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院临床检验中心心血管病研究所,北京100037

出　　处：《中华医院感染学杂志》2010年第23期3809-3811,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究心血管病医院小儿外科术后医院感染病原菌及其耐药性,为临床合理使用抗菌药物提供依据。方法分析医院2008年9月-2009年10月小儿外科术后的感染病原菌,并对其耐药性进行分析。结果分离的病原菌中,以革兰阴性杆菌为主,占72.4%;铜绿假单胞菌和鲍氏不动杆菌对头孢他啶、阿米卡星、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦的耐药率很低,为0～15.9%,亚胺培南和美罗培南是治疗肠杆菌科细菌最为有效的抗菌药物;革兰阳性球菌中,肠球菌属对青霉素、环丙沙星、左氧氟沙星、高浓度庆大霉素的耐药率较低,为0～20.0%,屎肠球菌的耐药率高于粪肠球菌;葡萄球菌属中以耐甲氧西林凝固酶阴性葡萄球菌为主,其对常用抗菌药物耐药率高,未出现耐万古霉素、替考拉宁和利奈唑胺的葡萄球菌属和肠球菌属。结论研究心血管病小儿外科术后医院感染的主要病原菌及其耐药性,对预防和控制医院感染,缩短住院时间,降低感染病死率有重要意义。OBJECTIVE To analyze the pathogend and their drug-resistance in pediatrics patients after surgery in Fuwai Cardiovascular Hospital and provide useful suggestions for clinical treatment.METHODS The pathogens were identified by VITEK32 and analyzed by Whonet5.4.RESULTS The isolated pathogens mainly consisted of Gram-negative bacilli（72.4%）.The Pseudomonas aeruginosa and Acinetobacter baumannii were much more sensitive to ceftazidime,amikacin,cefoperazone/sulbactam and piperacillin/tazobactam than other antibiotics（the resistance rates were 0-15.9%）.Imipenem and meropenem were the most effective antibiotics for the Enterobacteriaceae;Enterococcus faecalis was much more sensitive to antibiotics than E.faecium and both of them showed good susceptibility to penicillin,ciprofloxacin,levofloxacin and high-level gentamicin（the resistance rates were 0-20%）.Most coagulase negative Staphylococcus were resistant to oxacillin and showed low susceptibility to most antibiotics.No Gram-positive cocci were found to be resistant to vancomycin,tecpolanin and linezolid.CONCLUSIONS Analyzing the pathogens and their drug-resistance of pediatrics patients after surgery is very important to control nosocomical infections,shorten the hospital stay and lower the mortality rate.

关 键 词：心血管病 小儿外科 感染 病原菌 

分 类 号：R378[医药卫生—病原生物学]