2007-2010年神经外科医院感染病原菌分布及耐药率  

Distribution of pathogens causing nosocomial infections in neurosurgical department and drug resistance

作　　者：杨莎[1] 蔡雪林[1] 王利君[1] 张文坚[1] 瞿伟军[1] 徐放明[1] 

机构地区：[1]中南大学湘雅三医院医院感染控制中心,湖南长沙410013

出　　处：《中华医院感染学杂志》2012年第19期4390-4392,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解神经外科医院感染主要病原菌的耐药特点及变化趋势,为神经外科医院感染的临床用药及预防控制提供理论依据。方法采用前瞻性监测结合回顾性调查方法,对2007-2010年医院神经外科住院患者的临床资料进行分析、总结。结果 2007-2010年3549例神经外科住院患者医院感染率为11.44%;医院感染以下呼吸道为主,占61.08%,其次是颅内感染,占16.75%;医院感染主要病原菌为鲍氏不动杆菌、金黄色葡萄球菌、铜绿假单胞菌,分别占22.38%、22.03%、15.73%;铜绿假单胞菌对各种抗菌药物耐药率均>40.00%,对头孢他啶、美罗培南的耐药率最低,均为44.19%;鲍氏不动杆菌对头孢哌酮/舒巴坦耐药率最低,为14.04%,但近一年耐药率明显上升;尚未发现耐万古霉素、替考拉宁或利奈唑胺金黄色葡萄球菌。结论神经外科是医院感染的高危科室,持续系统地监测其医院感染的发生情况及耐药特点,对合理使用抗菌药物,预防控制医院感染有重要意义。OBJECTIVE To understand the characteristics of the drug resistance of the main pathogens causing nosocomial infections and the variation trend so as to provide theoretical evidence for the clinical use of antibiotics and the prevention and control of nosocomial infections in neurosurgicd department.METHODS By the means of prospective monitoring combined with retrospective survey,the clinical data of the hospitalized patients in neurosurgicd department during 2007-2010 were analyzed and summarized.RESULTS From 2007 to 2010,the case-time infection rate of 3549 patients in department of neurosurgery was 11.44%;the lower respiratory tract was the major site with infections,accounting for 61.08%,followed by intracalvarium infections（16.75%）;Acinetobacter baumannii（22.38%）,Staphylococcus aureus（22.03%）and Pseudomonas aeruginosa（15.73%）were the main pathogens causing nosocomial infections;the drug resistance rates of P.aeruginosa to various antibiotics were higher than 40.00%,the drug resistance rates to ceftazidime and meropenem were the lowest,which were both 44.19%;the resistance rate of A.baumannii to cefoperazone/sulbactam was the lowest（14.04%）,however,the resistance rate increased dramatically last year;no strains of S.aureus resistant to vancomycin,teicoplanin,and linezolid were found.CONCLUSION Neurosurgical department is a high-risk department of nosocomial infection.Continuous and systematic monitoring of the outbreak of nosocomial infections and drug resistance and reasonable use of antibiotics have great significance in the prevention and control of nosocomial infections.

关 键 词：神经外科 医院感染 耐药率 铜绿假单胞菌 鲍氏不动杆菌 金黄色葡萄球菌 

分 类 号：R378[医药卫生—病原生物学]