呼吸系统疾病患者发生双重病原菌感染的耐药性检测  

Distribution and drug resistance of pathogens causing dual infections in patients with respiratory system diseases

作　　者：陈振平[1] 刘学芬[1] 胡伟华[1] 夏伟[1] 

机构地区：[1]荆州市第一人民医院呼吸内科,湖北荆州434000

出　　处：《中华医院感染学杂志》2013年第13期3264-3266,共3页Chinese Journal of Nosocomiology

基　　金：湖北省教育厅重点项目(D20091202)

摘　　要：目的探讨呼吸系统疾病患者发生双重病原菌感染的菌群分布及耐药性分析,为临床合理用药提供参考。方法随机选取2008年2月-2011年7月因呼吸系统疾病于医院进行治疗的患者1392例,将其中发生医院双重感染患者69例作为研究对象,回顾性分析发生医院双重感染患者的病原菌分布及耐药性检测结果,并对结果进行统计分析。结果 1392例治疗患者中发生医院双重感染的患者为69例,感染发生率为4.9%;感染病原菌前3位依次为铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌,分别占30.4%、20.3%、15.9%;发生感染的患者检出病原菌对头孢类药物耐药性最高,耐药48株,耐药率为69.6%,与其他抗菌药物耐药率比较,差异有统计学意义(P<0.05);发生双重感染的69例患者中,危险因素居首位的是长期应用广谱抗菌药物67例,感染率为97.1%;其次为气管侵入性操作61例,感染率为88.4%。结论临床医师要及时监测病原菌变化及耐药趋势,以指导临床合理选用抗菌药物,并尽量减少侵入性操作,降低医院感染的发生。OBJECTIVE To discuss the distribution and drug resistance of the pathogens causing dual infections in the patient with respiratory system diseases so as to guide the reasonable clinical medication.METHODS From Feb,2008to Jul 2011,there were 1392patients with respiratory diseases in the hospital and 69patients with dual infections who were selected as the study objects.The distribution of the pathogens causing the dual infections and the drug resistance test result were retrospectively analyzed,and statistical analysis was performed.RESULTS Of 1392cases of patients who were treated in the hospital,the dual infections occurred in 69cases with the incidence rate of 4.9%;the Pseudomonas aeruginosa,Klebsieua pneumonia,and the Staphylococcus aureus were the top three species of pathogens,accounting for 30.4%,20.3%,and 15.9%,respectively;the drug resistance rate to cephalosporins was the highest（69.6%）,and there were 48cases;as compared with the drug resistance rate to other antibiotics,the difference was statistically significant（P〈0.05）.Of the 69cases of patients with dual infections,the long term use of broad spectrum antibiotics ranked the first place among the risk factors associated with the infections（67cases,97.1%）,followed by the tracheal invasive operation（61cases,88.4%）.CONCLUSION The clinicians should monitor the distribution of pathogens and trend of drug resistance to guide the reasonable clinical use of antibiotics and reduce the invasive operations so as to reduce the incidence of nosocomial infections.

关 键 词：呼吸系统疾病 医院双重感染 菌群分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]