肾病患者医院感染病原菌分布及耐药性研究  

Distribution and drug resistance of pathogens causing nosocomial infections in patients with kidney diseases

作　　者：石梅[1] 徐涛[1] 张金锋[1] 侯华[1] 邢建华[1] 王鹏霄[1] 

机构地区：[1]中国石化集团胜利石油管理局胜利医院肾内科,山东东营257055

出　　处：《中华医院感染学杂志》2014年第10期2391-2393,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(Y2006C02)

摘　　要：目的探讨住院慢性肾病患者医院感染病原菌的构成及耐药性,为临床诊治提供参考。方法以2010年1月-2013年8月住院治疗的744例慢性肾病患者作为研究对象,对其发生医院感染患者送检标本检出的病原菌的构成以及耐药性进行分析研究。结果 744例慢性肾炎患者中有89例患者并发医院感染,感染率为11.96%,其中狼疮性肾炎患者的感染率最高,为39.13%,其次为肾病综合征、慢性肾小球肾炎,分别占18.52%、12.90%;感染部位以上呼吸道为主,占37.08%,其次为下呼吸道和肺部分别占24.72%和13.48%;共分离出病原菌15株,其中革兰阴性菌11株占73.33%,以铜绿假单胞菌、大肠埃希菌、摩氏摩根菌为主,革兰阳性菌4株占26.67%,以金黄色葡萄球菌、表皮葡萄球菌为主;金黄色葡萄球菌和表皮葡萄球菌对头孢唑林、头孢吡肟、头孢他啶、头孢曲松、妥布霉素、氨曲喃、庆大霉素、头孢替坦敏感,耐药率均为0,铜绿假单胞菌和摩氏摩根菌对氨苄西林、头孢唑林、头孢他啶、环丙沙星、呋喃妥因、左氧氟沙星的耐药率为0,大肠埃希菌对头孢曲松耐药率为0,肺炎克雷伯菌对头孢他啶耐药率为0。结论住院慢性肾病患者医院感染病原菌以革兰阴性杆菌为主,且耐药性较高,临床治疗可以此为指导选择用药。OBJECTIVE To explore the distribution and drug resistance of pathogens causing nosocomial infections in hospitalized patients with chronic kidney diseases so as to provide basis for clinical treatment. METHODS A total of 744 patients with chronic kidney diseases, who were hospitalized from Jan 2010 to Aug 2013, were enrolled in the study, then the distribution and drug resistance of the pathogens causing infections isolated from. submitted specimens were analyzed. RESULTS Of the 744 patients with chronic nephritis, the nosocomial infections occurred in 89 cases with the infection rate of 11.96%, the incidence of the infections was the highest in the patients with lupus nephritis （39.13%）, followed by the patients with nephrotic syndrome （18.52%） and the patients with chronic glomerulonephritis （12.90%）. The patients with upper respiratory tract infections accounted for 37.08%, the patients with lower respiratory tract infections 24.72 %, the patients with pulmonary infections 13.48 %. A to- tal of 15 strains of pathogens have been isolated, including 11 （73.33%） strains of gram-negative bacteria and 4 （26.67 %） strains of gram-positive bacteria; the Pseudomonas aeruginosa, Escherichia coli, and Mount morganii were dominant among the gram-negative bacteria; the Staphylococcus aureus and Staphylococcus epidermidis were the predominant species of gram-positive bacteria. The drug resistance rates of the S. aureus and S. epidermi- dis to eefazolin, cefepime, ceftazidime, ceftriaxone, tobramycin, aztreonam, gentamicin, and cefotetan were 0; the drug resistance rates of the P. aeruginosa and M. rnorganii to ampicillin, cefazolin, ceftazidime, ciprofloxacin, nitrofurantoin, and levofloxacin were 0; the drug resistance rate of the E. coli to ceftriaxone was 0; the drug re- sistance rate of the K. pneumoniae to ceftazidime was 0. CONCLUSION The gram-negative bacilli are dominant among the pathogens causing nosocomial infections in the hospitalized patients with chronic kidney diseases and are highly

关 键 词：慢性肾病 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]