神经外科住院患者院内感染病原菌耐药性分析  

Drug resistance of pathogens of nosocomial infection in Department of Neurosurgery

作　　者：周至品[1] 叶晓雪[1] 洪翰明[1] 胡栓贵[1] 黄进能[1] 赖彦冰 

机构地区：[1]广西中医药大学附属瑞康医院,广西南宁530011

出　　处：《现代预防医学》2017年第3期542-545,共4页Modern Preventive Medicine

基　　金：广西自然科学基金面上项目(2014GXNSFAA118209)

摘　　要：目的了解神经外科住院感染患者院内感染病原菌分布特点及耐药情况,为临床合理用药与制定防控对策提供依据。方法分析2012年1月-2013年12月某院神经外科诊断为医院内感染患者分离的病原菌及体外药敏结果。结果分离得146株病原菌,呼吸道标本来源118株(80.82%),尿液17株(11.64%),血液6株(4.10%),脑脊液4株(2.74%);革兰阴性菌130株(89.04%),肺炎克雷伯杆菌、鲍曼不动杆菌、大肠埃希氏菌和铜绿假单胞菌位于前列;革兰阳性菌11株(7.53%),以金葡萄球菌和溶血葡萄球菌为主;真菌5株(3.40%),以假丝酵母菌为主。革兰氏阴性菌高度耐药,对美罗培南和亚胺培南的耐药率:肺炎克雷伯杆菌、大肠埃希氏菌0.00%,铜绿假单胞菌12.50%,鲍不动杆菌65.00%以上;肺炎克雷伯杆菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星耐药率分别为16.50%、4.40%、18.15%,大肠埃希氏菌和鲍曼不动杆菌仅对头孢哌酮钠/舒巴坦钠耐药率分别为5.88%,4.54%。铜绿假单胞菌对环丙沙星、左氧氟沙星耐药率0.00%。革兰阳性球菌皆为葡萄球菌,耐甲氧林葡萄球菌检出率81.81%,对氯霉素和左氧氟沙星耐药率皆小于30.00%,对利奈唑胺和万古霉素敏感率100.00%。结论神经外科病原菌耐药严重,临床用药应严格落实抗菌药使用管理办法和疾病治疗指南,根据药敏结果合理使用抗菌药物,以控制或延缓耐药菌的产生。Objective To investigate the distribution characteristics and drug resistance of pathogenic bacteria from patients with nosoeomial infection in neurosurgery, and to provide reference for rational clinical therapy and development of control measures. Methods The data about epidemiology and antimicroblal - resistance of pathogenic bacteria isolated from patients with nosocomial infection in neurosurgery from January 2012 to December 2013 were analyzed retrospectively. Results 146 strains were isolated,including 118 （ 80.82% ） from respiratory tract, 17 （ 11.64% ） from urinary tract, 6 strains （4. 10% ） from blood,4 strains （ 2.74% ） from cerebrospinal fluid. 130 strains （ 89.04% ） were gram - negative bacteria, mainly Klebsiella pneumoniae, Acinetobacter baumannii, E. coli and Pseudomonas aeruginosa, 11 strains （7.53%） were gram - positive bacteria, mainly Staphylococcus aureus and Staphylococcus haemolytics,5 strain（3.40% ）were fungus, mainly Candida. Gram -negative bacteria were highly drug resistant to antibiotics. The drug - resistant rate of Klebsiella pneumoniae and E. Coli to meropenem and imipenem were O. 00% ,Pseudomonas aeruginosa＇s was 12.50% , baumannii was exceeded 65.00%. The drug -resistant rate of Klebsiella pneumoniae to cefoperazone/shubactam, piperacillin/tazobactam and Amikacin were 16.50%,4.40% and 18.15 % , respectively;The drug - resistant rate of E. coli and Acinetobacter baumannii to cefoperazone/shubactam were 5.88 % and 4.58% ,respectively. The drug - resistant rate of Pseudomonas aeruginosa to ciprofloxacin and levofloxacin were 0.00%. The gram - positive coccus isolated were all Staphylococcus aureus, the drug - resistant rate of the Staphylococcus aureus to methillin was 81.81% , chloramphenicol and levofloxacin were less than 30.00% , linezolid and vancomycin were 100.00%. Conclusion The drug resistance of pathogenic bacteria isolated from neurosurgery is serious. Clinical therapy should strictly implement according to the measures for the management of a

关 键 词：神经外科 病原菌 耐药性 

分 类 号：R117[医药卫生—公共卫生与预防医学]