介入手术患者医院感染的病原菌分布及耐药性分析  

Distribution and Drug Resistance of Pathogens Causing Postoperative Noso-comial Infections in Interventional Operation Patients

作　　者：王娜[1] 刘玉珂[1] 李少侠[1] 

机构地区：[1]河南省洛阳正骨医院,河南洛阳471002

出　　处：《中国卫生产业》2015年第9期194-195,198,共3页China Health Industry

基　　金：河南省中医药科学研究资金项目(2013ZY02068)

摘　　要：目的了解介入治疗术后患者医院感染的常见病原菌分布及耐药情况,为临床合理使用抗菌药物,控制医院感染提供科学依据。方法回顾性调查医院2008年3月—2014年3月介入手术后患者医院感染的临床现状,统计分析225株病原菌的药敏试验结果。结果分离的225株病原菌中革兰阴性杆菌138株,占61.3%,主要为大肠埃希菌(25.8%),铜绿假单胞菌(19.1%)和鲍氏不动杆菌(8.9%);革兰阳性球菌79株,占35.1%,主要为金黄色葡萄球菌(15.6%)及凝固酶阴性葡萄球菌(11.5%);真菌8株,占3.6%。药敏试验结果显示分离的多数细菌耐药性均较高,大肠埃希菌和铜绿假单胞菌对常用的抗菌药物氨苄西林和头孢类的耐药率均大于60.0%,对亚胺培南、阿米卡星和妥布霉素的耐药率较低,均小于20.0%;金黄色葡萄球菌和凝固酶阴性葡萄球菌对万古霉素和替考拉宁均较敏感,尤其是对万古霉素100%敏感,而对青霉素、氨苄西林、红霉素、环丙沙星、克林霉素和左氧氟沙星的耐药率较高,均大于50.0%。结论条件致病菌已成为介入手术后患者医院感染的重要病原菌,临床医师应严格按照细菌学培养及药敏试验结果合理应用抗菌药物,采取有效措施积极预防和控制医院感染。Objective To investigate the clinical distribution and drug resistance of pathogens causing infections in patients of interventional operation, to provide the scientific evidence for clinical controlling of them. Methods The clinical status of pathogens causing infections in patients of interventional operation from Mar. 2008 to Mar. 2014 was investigated retrospectively. The suscep-tibility testing results of 225 cases were analyzed statistically. Results Of 225 strains of pathogens isolated,including 138（61.3%）stains of gram-negative bacilli,Escherichia coli（25.8%）, Pseudomonas aeruginosa（19.1%）and Acinetobacter baumannii（8.9%）were the most common gram-negative bacteria;79（35.1%） stains of gram-positive bacilli,Staphylococcus aureus（15.6%） and coagulase-negative Staphylococcus（11.5%）were the most common gram-positive bacteria;8（3.6%） stains of fungus.the drug susceptibility testing demonstrated that the drug resistance of most of the pathogens was high,the drug-resistance rates of Escherichia coli（25.8%）and Pseudomonas aeruginosa to ampicillin and cephalosporins were all above 60.0%,to imipenem, amikacin and obramycin were all less than 20.0%;Staphylococcus aureus and coagulase-negative Staphylococcus were susceptible to vancomycin and teicoplanin,100% sensitive to vancomycin,the resistance rate to penicillin,ampicillin,erythromycin,ciprofloxacin,clindamycin and levofloxacin were all above 50.0%. Conclusion The opportunistic pathogens has become the major pathogens of interventional operation patients with hospital infection,The clinical should prescribe the antibiotics reasonably according to etiology,take effective measures to prevent and control infection.

关 键 词：介入手术 医院感染 细菌分布 耐药性 

分 类 号：R19[医药卫生—卫生事业管理]