胃肠外科住院患者医院感染病原菌及耐药性分析  

Drug resistance of pathogenic bacteria causing hospital infections in patients in department of gastrointestinal surgery

作　　者：诸云华[1] 张庆[1] 王向群[1] 

机构地区：[1]杭州市余杭区第一人民医院普外科,浙江杭州311100

出　　处：《中华医院感染学杂志》2014年第11期2649-2651,共3页Chinese Journal of Nosocomiology

基　　金：浙江省科技厅研究基金资助项目(2007C30037)

摘　　要：目的研究胃肠外科住院患者医院感染的病原菌分布,并对其耐药性进行分析,以指导临床合理选用抗菌药物。方法对2011年1月-2012年12月胃肠外科住院的166例患者感染病原菌进行分离培养,采用K-B琼脂法进行药敏试验,药敏试验结果判定严格按照NCCLS标准。结果胃肠外科2 831例住院患者中发生医院感染166例,感染率5.86%;感染部位以呼吸道、泌尿生殖道、消化系统感染为主,分别占25.09%、21.69%和18.67%;标本来源中粪便42份、尿液34份、创口27份,分别占24.14%、19.54%、15.52%;共分离出病原菌174株,其中检出革兰阳性菌78株占44.83%、革兰阴性菌96株占55.17%,主要革兰阳性菌对利奈唑胺、替考拉宁和妥布霉素的耐药率较低,均<0.70%,主要革兰阴性菌对亚胺培南、美罗培南和交沙霉素的耐药率较低,均<12.00%。结论胃肠外科手术后住院患者医院感染率较高,应采取措施控制感染的发生,若发生感染,首先分离培养病原菌,对其耐药性进行分析,选取耐药率较低的抗菌药物进行及时的治疗。OBJECTIVE To study the distribution and drug resistance of pathogenic bacteria causing hospital infections in patients in department of gastrointestinal surgery so as to provide basis for the reasonable clinical medication and treatment. METHODS The pathogenic bacteria of 166 cases who hospitalized from Jan 2011 to Dec 2012 were isolated and cultured, the drug sensitivity tests were conducted by using K-B method,drug sensitive test result judgement strictly according to NCCLS standard. RESULTS The hospital infections occurred in 166 of 2831 patients with the infection rate of 5.86 %. The nosocomial infections mainly occurred in respiratory tract, urogenital tract,digestive system, with proportion of 25. 09%, 21. 69%,18. 67% respectively. Patient specimen pathogen distribution was.. the feces 42 strains accounted for 24.14%, urine 34 strains accounted for 19.54%, the wound site 27 strains accounted for 15. 52%. A total of 174 strains of pathogenic bacteria were isolated, of which 78 strains gram-positive,accounted for 44.83% ,96 strains of gram-negative,accounted for 55.17 %. G＋ bacteria had a low resistance to linezolid, teicoplanin and tobramycin, all less than 0.70%, G- bacteria had a low resistance to faropenem sodium, meropenem and josamycin, all less than 12.00%. CONCLUSIONS Hospital infection rate of hospitalized patients after gastrointestinal surgery was high, measures should be taken to control infections. If the infection occurs,the first is to cultivate, analyze its resistance, the low resistance antibacterial should be chosen to treat infections.

关 键 词：胃肠外科 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]