重症肝病患者医院感染病原菌分布与耐药性研究  

Hospital infections in patients with severe liver disease and clinical features of drug resistance

作　　者：夏迎春[1] 黄笑夏[1] 郑志勇[1] 黄曦[1] 

机构地区：[1]温州市中医院药剂科,浙江温州325000

出　　处：《中华医院感染学杂志》2015年第8期1733-1734,1737,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅科技基金资助项目(2013KYA871)

摘　　要：目的探讨重症肝病患者发生医院感染时病原菌的临床分布特点及其耐药性分析研究,为临床治疗提供理论参考依据。方法将2009年10月-2013年10月医院收治的480例重症肝病患者作为研究对象,对患者的腹水、尿液、血液以及痰液等分别分离并培养,并对病原菌的临床分布特点及耐药性进行统计分析,采用SPSS14.0软件进行统计处理。结果 480例重症肝病患者发生医院感染118例,感染率为24.5%,共分离出152株病原菌,其中以革兰阴性菌为主,共105株占69.1%,前3位病原菌分别为大肠埃希菌、凝固酶阴性葡萄球菌以及肺炎克雷伯菌,大肠埃希菌对氨苄西林及头孢曲松等的抗菌药物的耐药率较高,分别为76.4%、43.6%,对于亚胺培南以及阿米卡星和头孢哌酮/舒巴坦比较敏感,耐药率分别为0、10.9%、9.1%。结论重症肝病的患者医院感染率较高,大肠埃希菌以及凝固酶阴性葡萄球菌为感染的主要病原菌,并且其耐药性也比较高。OBJECTIVE To discuss the clinical distribution and drug resistance of pathogens of hospital infection in patients with severe liver disease so as to provide theoretical basis for clinical treatment.METHODS The 480 patients with severe liver disease admitted to hospital in Oct.2009 to Oct.2013 were enrolled as the research subjects.Ascites,urine,blood and sputum from patients were isolated and cultured,and the statistical analysis was conducted on clinical characteristics of the distribution of pathogens and drug resistance.The software SPSS14.0was used for statistical analysis.RESULTS Hospital infection occurred in 118 of 480patients with severe liver disease,the infection rate was 24.5%and 152 pathogens were isolated,mainly including 105gram-negative bacteria,accounting for 69.1%.And the top three kinds of pathogens were Escherichia coli,coagulase-negative Staphylococci,and Klebsiella pneumoniae.E.coli was highly resistant to ampicillin and ceftriaxone with the resistant rate of 76.4% and 43.6%,but sensitive to imipenem,amikacin and cefoperazone/sulbactam with the drug resistance rates of 0,10.9%,and 9.1%.CONCLUSIONPatients with severe liver disease have high incidence of hospital infections,E.coli and coagulase-negative Staphylococci are the main pathogens,and their resistance is relatively high.

关 键 词：重症肝病 感染 临床特点 耐药性 

分 类 号：R378[医药卫生—病原生物学]