手术患者医院感染病原菌的耐药性研究  

Drug resistance of pathogens causing nosocomial infections in patients undergoing surgeries

作　　者：刘江梅[1] 郑君[1] 鞠鑫[2] 张安美[1] 丁彬[1] 

机构地区：[1]潍坊市人民医院麻醉科,山东潍坊261041 [2]东南大学医学院心胸外科,江苏南京211189

出　　处：《中华医院感染学杂志》2015年第12期2715-2717,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(1400171148)

摘　　要：目的：探讨手术患者医院感染病原菌耐药性及临床特征，为临床抗菌药物的应用提供参考依据。方法收集2012年2月－2015年2月在医院行手术的950例患者临床资料，采集发生医院感染患者各类标本分离并鉴定病原菌，分析病原菌对抗菌药物的耐药性，数据采用SPSS16．0统计软件进行分析。结果950例手术患者中共有80例发生医院感染，感染率为8．4％；共分离出93株病原菌，其中革兰阳性菌25株占26．9％、革兰阴性菌61株占65．6％、真菌7株占7．5％；革兰阳性菌对青霉素G、苯唑西林、氨苄西林、环丙沙星耐药率均＞50．0％，对利福平敏感性最高，其次是克林霉素和米诺环素；革兰阴性菌对头孢吡肟、头孢曲松、头孢他啶、环丙沙星、哌拉西林、氨曲南、头孢唑林、妥布霉素的耐药率达50．0％～100．0％，对亚胺培南、米诺环素敏感性较高。结论手术患者医院感染的主要致病菌为革兰阴性菌，病原菌对抗菌药物显示出较高的耐药性；采取针对性措施，严格控制抗菌药物使用是降低医院感染的关键。OBJECTIVE To explore the drug resistance of the pathogens causing nosocomial infections in the patients undergoing surgeries and analyze the clinical characteristics so as to provide guidance for clinical use of antibiotics .METHODS The clinical data were collected from 950 patients who underwent the surgeries from Feb 2012 to Feb 2015 ,then the patients with nosocomial infections were sampled for isolation and identification of pathogens ,the drug resistance of the pathogens was observed ,and the statistical analysis was performed with the use of SPSS16 .0 software .RESULTS The nosocomial infections occurred in 80 of 950 patients undergoing surgeries ,with the infection rate of 8 .4% .A total of 93 strains of pathogens have been isolated ,including 25 （26 .9% ） strains of gram‐positive bacteria ,61 （65 .6% ） strains of gram‐negative bacteria ,and 7 （7 .5% ） strains of fungi . The drug resistance rates of the gram‐positive bacteria to penicillin G , oxacillin , ampicillin , and ciprofloxacin were more than 50 .0% ;the drug susceptibility rate to rifampicin was highest , followed by clindamycin and minocycline .The drug resistance rates of the gram‐negative bacteria to cefepime ,ceftriaxone , ceftazidime ,ciprofloxacin ,piperacillin ,aztreonam ,cefazolin ,and tobramycin ranged from 50 .0% to 100 .0% ;the strains were highly susceptible to imipenem and minocycline .CONCLUSIONS The gram‐negative bacteria are the predominant pathogens causing nosocomial infections in the patients undergoing surgeries ,and the pathogens are highly drug‐resistant .It is the key to take targeted measures and reasonably use antibiotics so as to reduce the incidence of nosocomial infections .

关 键 词：手术患者 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]