NSICU医院感染分析  

Nosocomial infections in NSICU

作　　者：王春莉[1] 吴亚亭[1] 谭晓风[1] 宋艳红[2] 

机构地区：[1]解放军第101医院感染控制科,江苏无锡214044 [2]解放军第101医院检验科,江苏无锡214044

出　　处：《中华医院感染学杂志》2013年第21期5154-5156,共3页Chinese Journal of Nosocomiology

基　　金：江苏大学临床医学科技发展基金资助项目(JLY20120148)

摘　　要：目的分析神经外科重症监护病房(NSICU)医院感染的病原菌分布及耐药现状,为临床合理用药和控制医院感染提供依据。方法回顾性调查分析2011年1-12月NSICU分离出的467株病原菌分布及耐药率。结果 NSICU医院感染多发生在重型颅脑伤和高血压脑出血患者中;感染部位以呼吸道最多占75.8%;208例患者共分离出467株病原菌,其中革兰阴性杆菌291株占62.3%,革兰阳性球菌135株占28.9%,真菌41株占8.8%,排名前4位病原菌依次为金黄色葡萄球菌、鲍氏不动杆菌、肺炎克雷伯菌肺炎亚种、铜绿假单胞菌,分别占19.1%、16.3%、15.0%、9.6%;病原菌耐药率普遍较高,产ESBLs检出率为45.5%,耐甲氧西林葡萄球菌检出率为65.5%。结论 NSICU医院感染主要致病菌以革兰阴性杆菌为主,病原菌耐药率普遍较高,需加强对病原菌分布及耐药性的监测,指导临床合理应用抗菌药物。OBJECTIVE To analyze the distribution and drug resistance of the pathogenic bacteria causing nosocomial infections in neurosurgery intensive care unit （NSICU） so as to provide basis for the clinical reasonable use of antibiotics and the control of nosocomial infections. METHODS The distribution and drug resistance rates of the 467 strains of pathogens isolated from NSICU during Jan-Dec 2011 were retrospectively analyzed. RESULTS The nosocomial infections mainly occurred in the NSICU patients with severe craniocerebral iniury and hypertensive intracerebral hemorrhage, the respiratory tract was the predominant infection site, accounting for 75.8 %. Of totally 467 strains of pathogens isolated from 208 cases of patients, there were 291 （62.3%） strains of gram-negative bacteria, 135 （28.9% ） strains of gram-positive cocci, and 41 （8.8% ） strains of fungi. The Staphylococcus aureus （19. 1%）, Acinetobacter baurnannii （16. 3%）, subtype of Klebsiella pneurnoniae （15. 0%）, Pseudomonas aeruginosa （9. 6%） ranked the top four species of pathogens. The drag resistance rates of pathogens were generally higher, the detection rate of ESBLs-producing strains was 45.5%, and the detection rate of methicillin- resistant Staphylococcus aureus was 65.5 %. CONCLUSION The gram-negative bacteria are dominant among the pathogens causing nosocomial infections in NSICU , which are highly drug resistant, thus it is necessary for the hospital to strengthen the surveillance of drug resistance and distribution of pathogens so as to guide the rational use of antibiotics.

关 键 词：神经外科重症监护病房 医院感染 病原菌 分布 耐药性 

分 类 号：R181.32[医药卫生—流行病学]