耳鼻咽喉多重耐药细菌感染的相关研究  

Research on multidrug-resistant bacterial infection in otolaryngology patients

作　　者：林伟[1] 程金妹[2] 王英歌[2] 

机构地区：[1]福建医科大学附属第三医院耳鼻咽喉科,福州350000 [2]福建医科大学附属第一医院耳鼻咽喉科

出　　处：《山西医科大学学报》2012年第11期854-858,共5页Journal of Shanxi Medical University

基　　金：福建省教育厅教授基金资助项目(J-S6048)

摘　　要：目的了解耳鼻咽喉病人感染多重耐药细菌的分布,并分析其产生的环境及细菌耐药原因,探讨相关对策。方法收集我院2008-01～2012-01耳鼻咽喉病人感染多重耐药细菌资料,并按社区感染及医院感染进行统计,并分析耐药细菌检出前抗生素使用的天数与检出率进行相关性。结果社区感染率(10.43%)大于医院感染率(3.93%),差异有统计学意义(P<0.05);其中社区感染中以耳鼻咽喉的慢性炎症为主,致病多重耐药菌以革兰阳性菌金黄色葡萄球菌为主(34.4%);医院多重耐药菌感染主要发生在耳鼻咽喉头颈部恶性肿瘤围手术期,以革兰阴性菌铜绿假单胞菌感染为主(30.4%);医院感染多重耐药的金黄色葡萄球菌及铜绿假单胞菌的耐药率与社区感染差异无明显统计学意义(P>0.05)。抗生素使用时间小于7 d感染多重耐药菌检出率(0.63%),较使用时间超过7 d检出率低,差异有统计学意义(P<0.05)。结论应区分耳鼻咽喉多重耐药菌的感染性质,合理使用抗生素,提高标本送检率,减少耳鼻喉多重耐药菌感染的发生。Objective To investigate the distribution of multi-drug resistant （MDR） bacterial infection in patients with otolaryngology diseases, and analyze its environment and causes of bacterial resistance, and to explore the related measures. Methods The clinical data of multi-drug resistant bacterial infections in otolaryngology patients from January 2008 to January 2012 were analyzed according to community and hospital. The correlation between drug resistance detection rate and the days of antibiotic use were analyzed. Results The community acquired infection rate was higher than that of nosocomial infection （10.43% vs 3.93% , P 〈 0.05 ）. Community ac-quired infections were mainly caused by chronic inflammation, and the multiple drug-resistant bacterium was mainly on gram-positive Staphylococcus aureus which accounted for 34.4%. However, the hospital infections mainly occurred in perioperative period of otolaryn-gology head and neck malignant tumors, and the multiple drug-resistant bacterium focused on gram-positive Pseudomonas aeruginosa （ 30.4% ）. The resistance rates of Staphylococcus aureus and Pseudomonas aeruginosa in hospital infection were almost equal to those in community infection（P 〉0.05）. The detection rate of multi-drug resistant bacterial infection which was treated by the antibiotics less than 7 days （0.63 % ） was lower than that over 7 days （ P 〈 0.05 ）. Conclusion The antibiotics should be rationally used according to the infection types of otolaryngology muhiple drug-resistant bacteria to reduce the occurrence of otolaryngology multiple drug-resistant infections and increase the detection rate of specimens.

关 键 词：耳鼻咽喉感染 多重耐药细菌 医院感染 

分 类 号：R763[医药卫生—耳鼻咽喉科]