某中医院手术切口感染病原菌分布及耐药性分析  

Analysis of Pathogen Distribution and Drug Resistance of Operative Incision Infection in a TCM Hospital

作　　者：薛世萍[1] 乔登嫣[2] 程麦莉[2] 石丽丽[2] 

机构地区：[1]甘肃省中医药研究院,甘肃兰州730050 [2]甘肃省中医院

出　　处：《西部中医药》2015年第6期74-76,共3页Western Journal of Traditional Chinese Medicine

摘　　要：目的:了解中医院手术切口感染的细菌分布及耐药性,为预防性选用抗菌药物及临床抗感染提供依据。方法:回顾2010年10月至2013年10月手术后切口感染患者资料,对患者基本信息、细菌分布及耐药性进行分析。结果:197例手术切口感染患者共检出细菌153株,检出的菌株中耐药菌株占69.28%。革兰氏阳性菌株54株,占细菌的35.29%,排列前三位的是金黄色葡萄球菌、表皮葡萄球菌和中间葡萄球菌;革兰氏阴性菌99株,占细菌的64.71%,排列前三位的分别是鲍曼不动杆菌、阴沟肠杆菌和大肠埃希菌。鲍曼不动杆菌对头孢噻肟、头孢他啶、庆大霉素、妥布霉素、左氧氟沙星的耐药率都在90%左右。阴沟肠杆菌对氨苄西林、哌拉西林的耐药率都超过了75%,而对阿米卡星、左氧氟沙星的耐药率较低。大肠埃希菌对氨苄西林、哌拉西林的耐药率均在90%左右,对头孢西丁、阿米卡星、头孢他啶的耐药率较低。金黄色葡萄球菌对庆大霉素、哌拉西林、青霉素、红霉素、头孢噻肟、头孢他啶、头孢吡肟这几种抗菌药物的耐药率均超过了80%,而对环丙沙星和左氧氟沙星的耐药率较低。表皮葡萄球菌对青霉素、红霉素、哌拉西林、左氧氟沙星、环丙沙星、头孢西丁的耐药率较高,对头孢噻肟、头孢吡肟的耐药率较低。结论:该中医院手术切口感染菌株的耐药性与其他医院有较大差别,临床医生应该加强手术切口的感染防控,参照药敏结果合理选择抗菌药物。Objective： To provide the reference for the use of antibacterials and clinical anti-inflammation prophylaxis by investigating pathogen distribution and drug resistance of operative incision infection in a TCM hospital. Methods： The data of the patients suffering from operative incision infection hospitalized from December, 2010 to December, 2013 was surveyed, basic information, pathogen distribution and drug resistance of the patients were analyzed. Results： All 153 bacterial strains were detected in 197 patients with operative incision infection, there were drug-resistance strains occupied 69.28% among the bacterial strains. There were 54 strains of Gram-positive bacteria, which reached 35.29%, the top three Gram-positive bacteria were Staphylococcus aureus （SA）, Staphylococcus epidermidis and Staphylococcus intermedius; there were 99 strains of Gram-negative bacteria, which took up 64.71%, the top three Gram-negative bacteria were Bauman Acinetobacter, Enterobacter cloacae and Escherichia coli. The drug resistance rates of Bauman Acinetobacter to cefotaxime, ceftazidime, Gentamicin, Tobramycin, Levofloxacin, even imipenem and Meropenem were around 90%. Drug resistant rates of Enterobacter cloacae to ampicillin, piperacillin and cefatriaxone were higher than 75%, while the rates resistant to amikacin, piperacillin/Tazobactam, Levofloxacin were lower. Drug resistant rates of Escherichia coli to ampicillin and piperacillin were more than 90%, while the rates resistant to cefoxitin, amikacin and ceftazidime were lower. The drug resistant rates of SA to Gentamicin, piperacillin, Penicillin, Erythromycin, cefotaxime, ceftazidime and cefepirne exceeded 80%, while the rates to ciprofloxacin and Levofloxacin were lower. Drug resistant rate of Staphylococcus epidermidis to Penicillin, Erythromycin, piperacillin, Levofloxacin, ciprofloxacin and cefoxitin were higher, while the rates to cefotaxime and cefepime were lower. Conclusion： Drug resistance of bacterial strain in the operative incision shows greater di

关 键 词：中医院 手术切口感染 耐药率 

分 类 号：R978.1[医药卫生—药品]