肛肠科医院感染特点与多药耐药菌感染的分析  

Characteristics of nosocomial infections in patients of anorectal department and prevalence of multidrug-resistant bacteria infections

作　　者：王世华[1] 潘娟[2] 刘桂花[3] 祁芝花 张海云[2] 

机构地区：[1]青海省中医院院感科,青海西宁810000 [2]青海省中医院手术室,青海西宁810000 [3]青海省中医院普外科,青海西宁810000

出　　处：《中华医院感染学杂志》2015年第10期2213-2215,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81201662)

摘　　要：目的探讨肛肠科医院感染特点及病原菌多药耐药性,为预防和治疗肛肠科医院感染提供理论依据。方法选取2012年1月-2014年6月入院的634例肛肠手术患者,对其临床资料进行回顾性分析,研究患者医院感染类型、感染病原菌及多药耐药菌分布。结果 634例肛肠手术患者中98例发生医院感染,感染率为15.46%;主要感染类型为手术切口、呼吸道、泌尿道及胃肠道感染;共分离出病原菌98株,其中革兰阴性菌59株占60.20%,革兰阳性菌25株占25.51%,真菌12例占12.25%;大肠埃希菌、肺炎克雷伯菌、脆弱拟杆菌、金黄色葡萄球菌、表面葡萄球菌具有多药耐药性;大肠埃希菌对头孢曲松、头孢他啶、阿莫西林/克拉维酸、加替沙星耐药率均为100.00%;肺炎克雷伯菌对头孢曲松、头孢吡肟、头孢他啶、阿莫西林/克拉维酸耐药率较高,>75.00%;金黄色葡萄球菌与表皮葡萄球菌对青霉素、头孢唑林、阿莫西林/克拉维酸耐药率>90.00%。结论肛肠科医院感染率较高,感染病原菌以革兰阴性菌为主,对常用抗菌药物均产生了较严重的耐药性,临床应根据药敏试验结果合理选择抗菌药物,减少耐药株的产生。OBJECTIVE To explore the characteristics of nosocomial infections in the patients of anorectal depart‐ment and observe the drug resistance of multidrug‐resistant pathogens so as to provide theoretical basis for preven‐tion and treatment of the nosocomial infections .METHODS A total of 634 patients who underwent the anorectal surgery in the hospital from Jan 2012 to Jun 2014 were enrolled in the study ,then the clinical data of the partici‐pants were retrospectively analyzed ,and the types of nosocomial infections and the distribution of pathogens and multidrug‐resistant bacteria were observed .RESULTS The nosocomial infections occurred in 98 of 634 patients un‐dergoing the anorectal surgery ,with the infection rate of 15 .46% ;the surgical incision ,respiratory tract ,urinary tract ,and gastrointestinal tract were the main infection sites .Totally 98 strains of pathogens have been isolated , including 59 （60 .20% ） strains of gram‐negative bacteria ,25 （25 .51% ） strains of gram‐positive bacteria ,and 12 （12 .25% ） strains of fungi .The Escherichia coli ,Klebsiella pneumoniae ,Bacillus fragilis ,Staphylococcus au‐reus ,and Staphylococcus epidermidis were multidrug‐resistant ;the drug resistance rates of the E .coli strains to ceftriaxone ,ceftazidime ,amoxicillin‐clavulanic acid ,and gatifloxacin were 100 .00% ;the drug resistance rates of the K .pneumoniae strains to ceftriaxone ,cefepime ,ceftazidime ,and amoxicillin‐clavulanic acid were more than 75 .00% ;the drug resistance rates of the S .aureus and S .epidermidis strains to penicillin ,cefazolin ,and amoxi‐cillin‐clavulanic acid were more than 90 .00% .CONCLUSION The incidence of nosocomial infections is high in the patients of anorectal department .The gram‐negative bacteria are dominant among the pathogens causing infections and are highly resistant to the commonly used antibiotics .It is necessary for the hospital to reasonably use antibiot‐ics based on the results of the drug susceptibility testing so as to re

关 键 词：肛肠科 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]