脑血管疾病患者医院感染的病原菌分布与耐药性分析  

Analysis on distribution and drug resistance of pathogenic bacteria in patients with cerebrovascular disease combined with hospital infections

作　　者：骆杭丽[1] 吴亦[1] 施婵宏[1] 

机构地区：[1]义乌市中心医院神经内科,浙江义乌322000

出　　处：《中华医院感染学杂志》2015年第4期788-790,共3页Chinese Journal of Nosocomiology

基　　金：浙江省义乌市科研基金资助项目(2010-3-20)

摘　　要：目的调查脑血管疾病患者医院感染的病原菌分布及其耐药性,指导临床合理使用抗菌药物。方法回顾性分析医院2010年1月-2014年1月122例脑血管疾病合并医院感染患者的临床资料,统计分析其感染病原菌种类及对常用抗菌药物的耐药率,数据采用SPSS13.0统计软件进行分析。结果 122例患者感染部位以下呼吸道感染最多47例、泌尿道25例、胃肠道感染21例,分别占38.5%、20.5%、17.2%;共分离出病原菌155株,其中革兰阴性菌81株占52.3%、革兰阳性菌59株占38.0%、真菌15株占9.7%;肺炎克雷伯菌对亚胺培南、阿米卡星和左氧氟沙星的耐药率较低,分别为0、11.1%和18.5%,金黄色葡萄球菌对万古霉素、美罗培南和庆大霉素的耐药率较低,分别为0、11.8%和17.6%,肠球菌属对万古霉素和美罗培南的耐药率较低,分别为0和7.1%。结论脑血管疾病患者医院感染的病原菌以革兰阴性菌为主,革兰阴性菌对亚胺培南和阿米卡星最敏感,革兰阳性菌对万古霉素和美罗培南最敏感,医院感染患者的治疗应参考病原菌药敏试验结果,合理选用抗菌药物,避免滥用广谱型抗菌药物,减少耐药菌株产生。OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria in patients with cerebrovascular disease combined with hospital infections,and to guide the rational use of antibiotics.METHODS The clinical data of 122 patients with cerebrovascular disease combined with hospital infections during Jan.2010 to Jan.2014 were retrospectively analyzed,and the types of pathogenic bacteria and drug resistance rate were analyzed.Data were analyzed with the statistical software SPSS13.0.RESULTS There were 47 cases of lower respiratory tract infections in the 122 patients,followed by 25 cases of urinary tract infections,and 21 cases of gastrointestinal infections,accounting for 38.5%,20.5%,and 17.2%.Totally 155 strains of pathogenic bacteria were isolated and identified,including 81 strains of gram-negative bacteria（52.3%）,59 strains of gram-positive bacteria（38.0%）,and 15 strains of fungi（9.7%）.Klebsiella pneumonia showed low rate of drug resistance to imipenem（0）,amikacin（11.1%）and levofloxacin（18.5%）.Staphylococcus aureus showed low rate of drug resistance to vancomycin（0）,meropenem（11.8%）and gentamicin（17.6%）.Enterococcus showed low rate of drug resistance to vancomycin（0）and meropenem（7.1%）.CONCLUSION The main pathogenic bacteria in patients with cerebrovascular disease combined with hospital infection were gram-negative bacteria.The gramnegative bacteria were the most sensitive to imipenem and amikacin,and gram-positive bacteria were the most sensitive to vancomycin and meropenem.It is beneficial for patients with hospital infections that clinician choose rational antibacterials according to the drug sensitive test,avoid abuse of broad-spectrum antibiotics so as to reduce the resistant strains.

关 键 词：脑血管疾病 医院感染 病原菌 耐药率 

分 类 号：R378[医药卫生—病原生物学]