骨科患者医院感染革兰阴性杆菌构成及药敏监测  

Constituent ratio and antibiotic susceptibility of gram-negative bacilli causing nosocomial infections in orthopedic patients

作　　者：程方雄[1] 黄宏耀[2] 杨宏伟[3] 

机构地区：[1]武汉市普爱医院检验科,湖北武汉430033 [2]随州市中心医院检验科,湖北随州441300 [3]湖北医药学院附属太和医院检验部,湖北十堰442000

出　　处：《中华医院感染学杂志》2012年第22期5144-5146,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解湖北地区3所医院的骨科患者医院感染分离的革兰阴性杆菌构成及对抗菌药物的敏感性,为临床医师选择抗菌药物提供参考依据。方法感染性标本采集运送和GPC分离培养严格遵照《全国临床检验操作规程》进行操作;药敏监测和评价采用CLSI推荐的K-B法标准,数据统计处理采用WHONET软件。结果骨科患者感染标本培养出677株革兰阴性杆菌,其对常用抗菌药物的敏感性出现不同程度的降低,但革兰阴性杆菌中肠杆菌科细菌对碳青霉烯类抗菌药物的敏感率为100.0%;而非发酵菌中的鲍氏不动杆菌和铜绿假单胞菌对亚胺培南和美罗培南分别出现20.8%～22.9%和10.5%～11.8%的耐药菌株。结论骨科患者医院感染革兰阴性杆菌的耐药性已非常严重,大型综合医疗机构应重视合理使用抗菌药物的管理工作,预防与控制多药耐药革兰阴性杆菌导致医院感染暴发流行。OBJECTIVE To understand the constituent ratio and antibiotic susceptibility of gram-nagtive bacilli（GNB） causing nosocomial infections isolated from orthopedic patients in 3 hospitals in Hubei and offer the reference for clinical use of antibiotics.METHODS Referring to National Guide to Clinical laboratory Procedures,the collection and delivery of infectious specimens and bacterial isolation and culture were performed.The drug susceptibility testing was performed by KB methods recommended by CLSI.The antimicrobial resistance profile was analyzed statistically by WHONET software.RESULTS Totally 677 strains of gram-negative bacilli were isolated from the infection specimens obtained from the orthopedic patients,the drug susceptibility of those isolates to commonly used antibiotics decreased in varying degree,however,100.0% of Enterobacteriaceae strains were susceptible to carbapenems,and in non-fermenting bacteria,the drug resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa to imipenem and meropenem varied respectively from 20.8% to 22.9% and from 10.5% to 11.8%.CONCLUSION Antimicrobial resistance of gram-negative bacilli causing nosocomial infections is distinctly serious.The large-scale comprehensive health care institutions should attach importance to the reasonable use of antibiotics to prevent and control the outbreak and prevalence of nosocomial infections caused by multidrug-resistant gram-negative bacilli.

关 键 词：骨科 革兰阴性杆菌 构成比 耐药性 

分 类 号：R378[医药卫生—病原生物学]