神经康复病房感染患者病原学分布及药敏分析  

Distribution and drug sensitivity of pathogenic bacteria in the rehabilitation ward

作　　者：曹珺[1] 薛福珍[1] 郑文[1] 

机构地区：[1]山东省交通医院院感科,山东省济南250031

出　　处：《中国基层医药》2015年第24期3787-3790,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：调查神经康复科住院患者细菌感染的现状、病原学分布及耐药性，以指导临床合理用药，为制定有效地预防控制措施提供科学依据。方法采用回顾性方法调查2011年1月至2014年12月某医院神经康复科收治的334例住院患者的临床资料，并采集患者感染部位的痰液、血液、脑脊液等标本对病原菌进行培养，观察并统计病原学培养结果。结果共检出病原菌334株，以革兰阴性菌为主，占83．53％；革兰阳性菌47株，占14．07％，真菌8株，占2．39％。感染的革兰阴性菌占前三位是大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌。革兰阳性菌以肠球菌为主。检出的主要革兰阴性菌对哌拉西林／他唑巴坦、头孢哌酮／舒巴坦、亚胺培南、美罗培南、头孢吡肟、阿米卡星的敏感率较高。其中大肠埃希菌对庆大霉素、哌拉西林、左氧氟沙星的耐药率均＞50％。肺炎克雷伯菌对庆大霉素、哌拉西林的耐药率＞50％。结论神经康复病房住院患者泌尿系、呼吸道感染率较高，以革兰阴性杆菌为主，应针对感染高危患者、重点环节，加强感染防控措施的落实，合理使用抗菌药物。Objective To investigate the bacterial infection status,etiology distribution and drug resistance of neurological rehabilitation hospitalized patients,to guide the clinical rational use of drugs,to provide a scientific basis for the development of effective prevention and control measures.Methods From January 201 1 to December 201 4,the clinical data of 334 hospitalized patients in department of neurological rehabilitation of our hospital were ret-rospectively analyzed.The pathogenic culture results were analyzed.Results There were 334 strains of pathogenic bacteria,83.53% of gram negative bacteria,47 gram positive bacteria（1 4.07%）,8 fungi（2.39%）.The top three infected gram negative bacterias were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa.The main Gram positive bacteria was enterococcus.The detective gram negative bacterias were mainly sensitive to piperacillin penicillin/tazobactam and cefoperazone /sulbactam and imipenem,meropenem,cefepime,amikacin.The resistance rate of Escherichia coli to gentamicin,piperacillin and levofloxacin was more than 50%.The resistance rate of Kleb-siella pneumoniae to gentamicin and piperacillin was more than 50%.Conclusion The infection rate of urinary tract and respiratory tract is higher in patients with neurological rehabilitation ward,and the infection rate is higher,and the main part of gram negative bacilli,should be aimed at high risk patients and key links,strengthen the implementation of infection prevention and control measures,rational use of antimicrobial agents.

关 键 词：病原 医院专科病房 神经 流行学方法 

分 类 号：R446.5[医药卫生—诊断学]