神经内科住院患者并发下呼吸道感染病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens causing lower respiratory tract infections in hospitalized patients of neurology department

作　　者：谭双[1] 

机构地区：[1]唐山工人医院神经内科,河北唐山063000

出　　处：《中华医院感染学杂志》2013年第12期3023-3025,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解引起神经内科住院患者下呼吸道感染的病原菌分布及其耐药性,为临床预防医院感染及用药提供科学依据。方法采集2009年1月-2011年12月医院神经内科并发下呼吸道感染的住院患者的下呼吸道分泌物并送检,应用法国生物梅里埃公司Bact/Alert 3D120全自动血培养仪及VITEK-2Compact全自动细菌鉴定、药敏分析系统进行细菌培养、鉴定及药敏分析。结果 2009年1月-2011年12月神经内科住院患者并发下呼吸道感染207例,共培养出菌株516株;检出的病原菌中,以革兰阴性菌为主437株占84.69%,主要以肺炎克雷伯菌、铜绿假单胞菌为主;革兰阳性菌85株占11.24%,主要以金黄色葡萄球菌为主;真菌21株占4.21%,主要以白色假丝酵母菌为主;其中,肺炎克雷伯菌对哌拉西林/他唑巴坦、亚胺培南、美罗培南等抗菌药物敏感,敏感率分别为98.14%、100.00%、100.00%,对氨苄西林、哌拉西林等抗菌药物耐药,耐药率为98.76%、70.19%,铜绿假单胞菌主要对头孢唑林、头孢呋辛酯、头孢呋辛钠敏感,敏感率均为100.00%,对磺胺甲噁唑/甲氧苄啶耐药,耐药率为98.65%,金黄色葡萄球菌对莫西沙星敏感,敏感率为78.05%,对红霉素、克林霉素等药物耐药,耐药率均为100.00%,真菌对氟康唑、两性霉素B等抗真菌药物普遍敏感,敏感率均为100.00%。结论医院感染是神经内科常见的并发症,引起神经内科住院患者下呼吸道感染的主要病原菌为革兰阴性菌,加强神经内科患者及抗菌药物的管理,监测感染病原菌的构成及耐药性,对预防医院感染非常重要。OBJECTIVE To explore the distribution and drug resistance of the pathogens causing lower respiratory tract infections in the hospitalized patients of the neurology department so as to provide scientific basis for preven- tion of nosocomial infections as well as for the use of antibiotics. METHODS The secretions of patients with lower respiratory tract infections in neurology department were collected from Jan 2009 to Dec 2012. The bacterial culture, identification, and drug susceptibility testing were conducted by France bioM6rieux Bact/Alert automated blood culture system 3D1Z0 and French Merieux VITEK Compact fully automated bacterial identification system. RESULTS From Jan 2009 to Dec 2011, there were 207 patients with lower respiratory tract infections, and totally 516 strains of pathogens were isolated. Of the isolated pathogens, there were 437 （84.69%） strains of gram-nega- tive bacteria, among which the Klebsiella pneumoniae and Pseudomonas aeruginosa were the predominant species; there were 85 （11.24%） strains of gram-positive bacteria among which the Staphylococcus aureus was the main species; there were 21（4.21%%） strains of fungi, among which Candida albicans was dominant. The K. pneu- moniae strains were sensitive to piperacillin/tazobactam, imipenem, and meropenem, but were resistant to amplcli lin and piperacillin. The P. aeruginosa strains were sensitive to cefazolin, cefuroxime axetil, and cefuroxime sodi- um, but were resistant to sulfamethoxazole/trlmethoprim. The S. aureus strains were sensitive to moxifloxaein, but were resistant to erythromycin and clindamycin. The fungi were generally sensitive to fluconazole and ampho- tericin. CONCLUSION Nosocomial infection is a common complication of the patiems in neurology department.The gram-negative bacteria are the predominant pathogens causing the lower respiratory tract infections in the hos pitalized patients. It is crucial for the prevention of nosocomial infections to strengthen the management of the pa tients and antibiotics a

关 键 词：神经内科 下呼吸道感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]