急性脑血管病患者医院感染病原菌耐药性研究  

Antimicrobial resistance of pathogenic bacteria causing nosocomial infections in patients with acute cerebrovascular disease

作　　者：金玉华[1,2] 黄宏耀[3] 肖小鸿 姜华[1] 张莉[1] 

机构地区：[1]湖北医药学院附属随州医院神经内科,湖北随州441300 [2]湖北医药学院附属随州医院科教科,湖北随州441300 [3]湖北医药学院附属随州医院检验科,湖北随州441300

出　　处：《中华医院感染学杂志》2016年第4期797-798,804,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅科研基金资助项目(JX6B38)

摘　　要：目的研究急性脑血管病住院患者医院感染的易感部位、病原菌分布及耐药性,为预防控制医院感染提供参考依据。方法选取2012年1月-2014年12月医院收治的2 988例急性脑血管病患者临床资料,统计其感染部位、病原菌分布及对抗菌药物的耐药率;药敏检测采用K-B法,检测数据采用WHONET 5.6软件处理。结果 2 988例急性脑血管病患者发生医院感染285例、336例次,感染率9.5%、例次感染率11.2%;感染部位以呼吸系统和泌尿系统为主,分别占54.2%和23.2%;送检标本培养出388株病原菌,其中革兰阴性菌占64.2%,革兰阳性菌占25.0%,真菌占10.8%;耐甲氧西林葡萄球菌检出率为54.2%,耐碳青霉烯类铜绿假单胞菌和鲍氏不动杆菌检出率分别为21.7%和32.6%,产ESBLs菌检出率为51.9%;革兰阴性菌对磺胺甲噁唑/甲氧苄啶耐药率最高,均>65.0%。结论急性脑血管病患者易诱发医院感染,且感染菌耐药性日益加剧,医院应将预防控制感染暴发和阻断耐药菌传播途径作为第一要务,以提高疾病治愈率。OBJECTIVE To explore the distribution and antimicrobial resistance of pathogenic bacteria causing nosocomial infections in patients with acute cerebrovascular disease and provide reference for prevention and control of the infections.METHODS The retrospective review was performed on the clinical data of 2 988 cases of hospitalized patients with acute cerebrovascular disease from Jan.2012 to Dec.2014.Infected sites,bacterial distribution and resistance rates were analyzed statistically.Susceptibility testing was carried out by K-B methods.The WHONET5.6software was used to process the data.RESULTS Totally 285cases（336case-times）of nosocomial infections were found among 2988 patients with acute cerebrovascular disease.The infection rate was 9.5% and the casetime infection rate was 11.2%.The infection sites were mostly respiratory tract（54.2%）,followed by urinary tract（23.2%）.Totally 388 pathogenic bacteria were isolated,including gram-negative bacteria（64.2%）,grampositive bacteria（25.0%）and fungi（10.8%）.Detection rate of methicillin-resistant Staphylococci（MRS）was54.2%.The isolating rates of carbopenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii were21.7% and 32.6%,respectively.The isolating rate of ESBLs-producing strains was 51.9%.The highest resistant rate of gram-negative bacteria was more than 65.0% to sulfamethoxazole/trimethoprim.CONCLUSION The patients with acute cerebrovascular disease were prone to nosocomial infections.The antimicrobial resistance was increasingly serious.Prevention and control of outbreak of nosocomial infections and blocking the spread of drugresistant strains should be the top priority for improvement of the cure rate of the disease.

关 键 词：急性脑血管病 医院感染 病原菌 耐药性 监测 控制 

分 类 号：R651.12[医药卫生—外科学]