普通外科病房病原体分布及其耐药性  

Distribution and drug resistance of pathogens isolated from a general sur- gery department

作　　者：金杰波[1] 张勇[1] 何涛[1] 李菊芳[1] 

机构地区：[1]玉溪市人民医院,云南玉溪653100

出　　处：《中国感染控制杂志》2013年第6期461-463,444,共4页Chinese Journal of Infection Control

摘　　要：目的调查某院普通外科病房病原体分布及其耐药性,为临床医生合理选择抗菌药物提供依据。方法对该院普通外科2011年1月—2012年12月临床送检各类标本分离的病原体种类、分布及耐药性进行回顾性分析。结果共分离病原体859株,其中革兰阴性(G-)菌563株(占65.54%),革兰阳性(G+)菌233株(占27.12%),真菌63株(占7.33%);G-菌以大肠埃希菌(40.40%)居多,G+菌以粪肠球菌(3.96%)居多,真菌主要为白假丝酵母菌。病原体标本来源主要为腹腔引流/抽出液(65.43%,562株),其次为伤口或切口分泌物(10.94%,94株)、痰液(9.90%,85株)、胆汁(6.75%,58株)等。肠杆菌科细菌对亚胺培南、美罗培南不耐药,对阿米卡星、阿莫西林/克拉维酸、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的耐药率均<20%,对头孢菌素的耐药率较高。鲍曼不动杆菌对亚胺培南、美罗培南的耐药率高达51.85%、47.37%,对其他大部分抗菌药物的耐药率均>60%,耐药率较低的是左氧氟沙星、阿米卡星,耐药率均<20%。G+球菌对万古霉素的耐药率<3.40%。结论该院普通外科住院患者医院感染主要病原体以G-菌为主,了解普通外科病房病原菌分布及加强细菌的耐药性监测,对临床医生合理选择抗菌药物,提高疗效,防止耐药菌株的产生及传播具有重要意义。ObjectiveTo investigate the distribution and drug resistance of pathogens isolated from a general surgery department.MethodsThe category,distribution, and drug resistance of pathogens isolated from patients in a general surgery department from January 2011 to December 2012 were analyzed retrospectively.ResultsA total of 859 isolates of pathogens were isolated，563 （65.54%） of which were gramnegative bacteria,233 （27.12%） were grampositive bacteria, and 63 （7.33%）were fungi. The most common gramnegative bacteria was Escherichia coli （40.40%）， the dominant grampositive bacteria was Enterococcus faecalis （3.96%）, Candida albicans was the major fungus.Most pathogens were isolated from peritoneal fluid（65.43%，562 isolates）,followed by wound or incisional secretion（10.94%，94 isolates）,sputum （9.90%，85 isolates）, and bile（6.75%，58 isolates）. Enterobacteriaceae were not resistant to imipenem and meropenem,and resistant rates to amikacin, amoxicillin/clavulanic acid,piperacillin/tazobactam and cefoperazone/sulbactam were all 〈20%,the resistant rates to cephalosporins were high. The resistant rate of Acinetobacter baumannii to imipenem and meropenem was 51.85% and 47.37% respectively，and to most antimicrobial agents were 〉60%, but to levofloxacin and amikacin were both 〈20%. The resistant rate of grampositive bacteria to vancomycin was 〈3.40%.ConclusionThe major pathogens isolated from inpatients in this general surgery department are gramnegative bacteria, survey on distribution and drug resistance of pathogens is important for the rational choice of antimicrobial agents, improvement of therapeutic efficacy,and prevention of the spread of drugresistant bacteria.

关 键 词：普通外科 病原体 抗药性 微生物 医院感染 合理用药 

分 类 号：R969.3[医药卫生—药理学]