外科患者感染病原菌分布及耐药性分析  

Analysis on infectious pathogens distribution and drug resistance in surgical patients

作　　者：刘芳[1] 曹晋桂[1] 何晓峰[1] 张虎[1] 吴镝[1] 马文杰[1] 焦立群[1] 

机构地区：[1]空军总医院感染管理科,北京100142

出　　处：《国际检验医学杂志》2015年第5期610-612,共3页International Journal of Laboratory Medicine

摘　　要：目的了解该院2007～2011年外科病区患者感染病原菌分布状况以及耐药现状,为外科手术患者抗感染治疗提供依据。方法采用VITEK全自动微生物鉴定仪鉴定细菌及真菌;用纸片扩散Kirby-bauer（KB）法测定外科病区患者中分离出的细菌的抗菌药物耐药性,并对其进行分析。结果共分离出1 218株病原菌,其中革兰阴性菌669株（55%）,革兰阳性菌440株（36%）,真菌109株（9%）。总体前五位的细菌依次为大肠埃希菌182株（15%）,铜绿假单胞菌171株（14%）,金黄色葡萄球菌105株（9%）,肺炎克雷伯菌86株（7%）和粪肠球菌61株（5%）。283株大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌中ESBLs菌株检出率为29.7%。耐甲氧西林金黄色葡萄球菌占到金黄色葡萄球菌的63%。葡萄球菌属及肠球菌属对多种抗菌药物的耐药率都在50%以上。肠杆菌科细菌对碳青霉烯类以及含酶抑制剂的复合抗菌药物比较敏感。不动杆菌属对头孢哌酮/舒巴坦的耐药率最低为21.1%。铜绿假单胞菌对含酶抑制剂的抗菌药物最为敏感,对头孢哌酮/舒巴坦耐药率最低为17.4%。结论外科患者临床分离的致病菌耐药现象比较严重,该研究为围手术期预防用药及感染治疗的经验用药提供了一定的依据。Objective To understand the infectious pathogens distribution and drug resistance in the surgical departments of our hospital from 2007 to 2011to provide the basis for the anti-infective therapy in the surgical patients.Methods TheVitek automatic microbial identification system was used to identify bacteria and fungi.The Kirby-bauer（KB）method was used to study the antibiotic resistance in the pathogens isolated from the patients in the surgical departments.Results 1218 strains of pathogens were isolated,including 669strains（55%）of Gram-negative bacteria,440strains（36%）of Gram-positive bacteria and 109strains（9%）of fungi.The top five of bacteria in turn were Escherichia coli in 182strains（15%）,Pseudomonas aeruginosa in 171strains（14%）,Staphylococcus aureus in 105strains（9%）,Klebsiella pneumoniae in 86strains（7%）and Enterococcus faecalis in 61strains（5%）.Among 283 strains of Escherichia coli,Klebsiella pneumoniae and proteus mirabilis,the detection rate of ESBLs producing strains was 29.7%.Methicillin-resistant Staphylococcus aureus（MRSA）accounted for 63% of Staphylococcus aureus.The resistance rates of Staphylococcus and Enterococcus to multiple antibacterial drugs were above 50%.Enterobacteriaceae bacteria were more sensitive to carbapenems as well as compound antibacterial drugs containing enzyme inhibitor.The lowest resistance rate of Acinetobacter to cefoperazone/sulbactam was 21.1%.Pseudomonas aeruginosa showed the most sensitive to compound antibacterial drugs containing enzyme inhibitor and its lowest resistance rate to cefoperazone/sulbactam was 17.4%.Conclusion The drug resistance phenomenon in the pathogens isolated from the surgical patients are relatively serious,this study provides some basis for the preventive antimicrobial drugs use in the perioperative period and the empirical medication in the infection therapy.

关 键 词：外科 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]