神经外科患者下呼吸道感染病原菌分布与耐药性分析  

Analysis of drug resistance and distribution of pathogens for lower respiratory tract infections in patients of neurosurgery department

作　　者：孙洪涛[1] 王延民[1] 魏正军[1] 李兆麟[1] 廖余平[1] 张赛[1] 

机构地区：[1]武警后勤学院附属医院脑科医院神经外科,天津300162

出　　处：《中华医院感染学杂志》2015年第3期534-536,共3页Chinese Journal of Nosocomiology

基　　金：天津市自然科学基金资助项目(12JCYBJC18500)

摘　　要：目的探讨神经外科患者下呼吸道感染的病原菌分布特点及对抗菌药物的耐药性,为神经外科预防医院感染及合理应用抗菌药物提供依据。方法收集医院2012年1月-2013年6月收治的972例神经外科下呼吸道感染患者的痰标本,对其进行病原菌检测及药敏试验,数据采用WHONET5.3软件进行统计分析。结果 972份痰培养标本检出病原菌286株,检出率为29.42%,其中革兰阴性菌173株占60.49%,革兰阳性菌82株占28.67%,真菌31株占10.84%,前4位病原菌依次为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌,分别占20.63%、14.33%、12.24%、9.79%;大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌对氨苄西林的耐药率为100.00%,肺炎克雷伯菌对亚胺培南的耐药率为0,革兰阳性菌对万古霉素、磺胺甲噁唑/甲氧苄啶耐药率较低,其中金黄色葡萄球菌和表皮葡萄球菌对万古霉素的耐药率为0,金黄色葡萄球菌对青霉素的耐药率为100.00%。结论神经外科住院患者下呼吸道感染病原菌主要为革兰阴性菌,主要病原菌的耐药形式较为严峻,应根据药敏试验结果严格使用抗菌药物,采取有效措施,控制医院感染的发生。OBJECTIVE To investigate the distribution of pathogenic bacteria in patients with lower respiratory tract infections in department of neurosurgery and their resistance against antimicrobial agents, so as to provide data support for prevention of nosocomial infections and reasonable use of antibiotics in neurosurgery department. METHODS The sputum culture results of 972 patients with lower respiratory tract infection in the neurosurgery department of our hospital were retrospectively analyzed from Jan. 2012 to Jun. 2013. RESULTS Among the 972 specimens of sputum culture, 286 strains of pathogenic bacteria were detected, the detection rate was 29.42%. The gram negative bacteria accounted for 60. 49%, gram positive bacteria accounted for 28. 67%, and fungi accounted for 10. 84%. The top four pathogens were Escherichia coli, Klebsielta pneumoniae, Staphylococcus aureus, and Pseudomonasaeruginosa, accounting for 20.63%, 14, 33%, 12.24% and 9.79%, respectively. The drug resistance rates of E. coli, K. pneumonia and P. aeruginosa to ampicillin were 100.00%,while the drug resistance rate of K. pneumonia to imipenem was 0. The resistance rates of gram positive bacteria to vancomycin and trimethoprim/sulfamethoxazole resistance rates were low. The drug resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to vancomycin were 0, and the drug resistance rate of S. aureus to benzylpenicillin was 100.00%. CONCLUSION The pathogenic bacteria in patients with lower respiratory tract infection in the neurosurgery department were dominated by gram-negative bacteria, and the drug resistance of these main pathogens was quite high. Antibiotics should be used strictly based on the results of drug sensitivity test, and efficient measures should be taken to control the nosocomial infections.

关 键 词：神经外科 下呼吸道感染 病原菌 耐药性 

分 类 号：R56[医药卫生—呼吸系统]