神经外科医院感染与耐药性分析  

Nosocomial infections in neurosurgery department and drug resistance

作　　者：王伟[1] 胡群亮[1] 

机构地区：[1]武警后勤学院附属医院神经外科,天津300162

出　　处：《中华医院感染学杂志》2012年第23期5266-5268,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨神经外科医院感染的易感部位、病原菌的种类及药物敏感性,以指导临床合理治疗。方法回顾性调查医院2009年7月-2011年5月神经外科住院患者的有关临床资料,对确诊医院感染的182例患者进行痰液培养,对分离出的主要病原菌进行药敏试验测定。结果神经外科住院1503例患者中,发生感染182例,感染率为12.11%;感染部位主要为下呼吸道,占59.89%,其次为上呼吸道、泌尿道、颅内、创口,分别占14.29%、10.99%、8.24%、3.84%;分离出病原菌269株,其中以铜绿假单胞菌居首位占24.91%,其次为肺炎克雷伯菌、金黄色葡萄球菌、大肠埃希菌、鲍氏不动杆菌,分别占23.05%、17.10%、12.64%、6.69%;大肠埃希菌、鲍氏不动杆菌及肺炎克雷伯菌对亚胺培南/西司他丁耐药率最低,分别为0、5.56%、1.61%,哌拉西林/他唑巴坦和万古霉素分别对铜绿假单胞菌和金黄色葡萄球菌的耐药率也较低,分别为17.91%、43.48%。结论医院感染中神经外科感染发病率明显高于其他科室,患者接受多项侵入性操作、抗感染药物的应用、患者免疫功能低下等是医院感染的危险因素;应加强医院监督管理及相关制度落实,有效控制感染率。OBJECTIVE To investigate the susceptible site, the kinds of pathogens and drug susceptibility of nosocomial infections in neurosurgery department, in order to guide the reasonable clinical therapy. METHODS The relevant clinical data of patients in neurosurgery were retrospectively investigated in recent 2 years, sputum culture was carried out with 182 definite nosocomial infection patients, and drug susceptibility testing was performed for the main detached pathogens. RESULTS Of 1503 patients enrolled in neurosurgery department, nosocomial infections occurred in 182 patients with the infection rate of 12.11%, the chief susceptible site was the lower respiratory traci （59.89 % ）, subsequently sites were the upper respiratory tract （14. 29 %）, urinary tract （ 10.99% ）, intracranial site（8.24% ） and wound （3.84 % ） ; totally 269 strains of pathogens were isolated, among which Pseudomonas aeruginosa ranked the first place, accounting for （24.91%）, followed by Klebsiella pneu- moniae （23.05 % ）, Staphylococcus aureus （ 17. 100/~） , Escherichia coli （ 12. 64 %） and Acinetobacter baumannii （6.69%） ; the drug resistance rates of A. baurnannii and K. pneumoniae to imipenem/cilastatin were the lowest, which were 0, 5. 56% andl. 61%, respectiuely. P. aeruginosa and S. aureus were resistant to piperacillin/ tazobactam and vancomycin the resistance rates were 17. 91%, and 43. 48%, respectiuely. CONCLUSION The incidence of nosocomial infections is significantly higher in the neurosurgery department than in other departments, the invasive operation, use of antibiotics, and low body immunity are the risk factors for nosocomial infections; it is necessary to intensify the supervision management and implement related systems so as to effectively control nosocomial infections.

关 键 词：神经外科 医院感染 病原菌 耐药率 

分 类 号：R181.34[医药卫生—流行病学]