泌尿外科患者医院感染病原菌调查分析  

Distribution of pathogenic bacteria causing nosocomial infections in patients of urology department

作　　者：李明果[1] 林芝[1] 李成山[1] 李皇[2] 

机构地区：[1]百色市人民医院泌尿外科,广西百色533000 [2]百色市人民医院微生物室,广西百色533000

出　　处：《中华医院感染学杂志》2013年第13期3269-3270,3273,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨泌尿外科患者发生医院感染的病原菌分布及耐药性,为泌尿外科患者的临床治疗提供依据。方法对166例泌尿外科患者进行医院感染判断,对确诊为医院感染的泌尿外科患者采集血液、尿液及痰液标本,进行相应的细菌培养,对培养后检出的病原菌结果进行统计分析。结果泌尿外科1066例患者中医院感染42例,其中尿道插管感染37例、手术伤口感染5例,医院感染率为3.9%;42例发生医院感染的泌尿外科患者中共送检标本140份,检出90株病原菌,检出率为64.3%,其中革兰阴性杆菌为62株占68.9%,革兰阳性杆菌为22株占24.4%,真菌6株占6.7%,排名前5位病原菌为大肠埃希菌、溶血葡萄球菌、铜绿假单胞菌、奇异变形菌及表皮葡萄球菌,分别占32.2%、11.1%、11.1%、11.1%、7.8%;革兰阳性菌对庆大霉素、红霉素、克林霉素、左氧氟沙星及磺胺甲噁唑/甲氧苄啶均有较强的耐药性,革兰阴性菌对庆大霉素、磺胺甲噁唑/甲氧苄啶、氨苄西林、头孢他啶及头孢匹肟有较强的耐药性;真菌对两性霉素B、伏立康唑、氟康唑、氟胞嘧啶以及伊曲康唑敏感。结论医院在对患者进行临床治疗时,应严格遵守抗菌药物使用原则,对抗菌药物使用进行规范化管理,并根据耐药性检测结果及时调整用药结构,更好地预防及控制泌尿外科的医院感染。OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria causing nosocomial infections in the patients of urology department so as to provide a solid basis for the therapeutic treatment.METHODS A total of 166patients in department of urology were analyzed.The indexes of blood,urine,sputum specimen collection,and corresponding bacterial culture were performed for the patients diagnosed as nosocomial infections,then the results were statistically analyzed.RESULTS Totally 42patients were diagnosed as nosocomial infections in 1066patients in the department of urology,among which there were 37cases of urethral catheterization infections and 5cases of surgical site infections,the incidence rate of nosocomial infections was 3.9%.Totally 140 copies of specimens were detected in 42patients with nosocomial infections in department of urology,and 90 strains of pathogenic bacteria were isolated with the isolation rate of 64.3%,among which there were 62strains of gram-negative bacilli（68.9%）,22strains of gram-positive bacilli（24.4%）,and 6strains of fungi（6.7%）.The Escherichia coli,Staphylococcus haemolyticus,Pseudomonas aeruginosa,Proteus mirabilis,and Staphylococcus epidermidis ranked the top five species of pathogens,accounting for 32.2%,11.1%,11.1%,11.1%,and 7.8%,respectively.The gram-positive bacteria were highly resistant to gentamicin,erythromycin,clindamycin,levofloxacin,and sulfamethoxazole/trimethoprim,the gram-negative bacteria were more resistant to gentamicin,sulfamethoxazole/trimethoprim,ampicillin,ceftazidime,and cefpiramide oxime,and the fungi were highly sensitive amphotericin B,voriconazole,fluconazole,cytosine,and itraconazole.CONCLUSION The principles of the use of antibiotics should be strictly abided in patients hospitalized,and the management of antibiotics should be standardized.The medication of patients with drug resistance should be adjusted according to the test results,it is also helpful to the prevention and control of nosocomial infections in the patients i

关 键 词：泌尿外科 医院感染 病原菌 分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]