外科住院患者感染病原菌的构成及耐药性分析  

The Distribution and Drug Resistance Analysis of Pathogens from Surgical Inpatients Infection

作　　者：赵德军 付维婵[2] 胡昭宇[2] 曹雁[2] 武静[2] 王发丽[2] 罗名媛 王世俏 

机构地区：[1]清镇市第一人民医院,清镇551400 [2]解放军第44医院,贵阳550009 [3]贵州医科大学,贵阳550002

出　　处：《国外医药（抗生素分册）》2017年第3期140-143,共4页World Notes on Antibiotics

摘　　要：目的通过了解某医院外科住院患者感染病原菌的构成及耐药情况,为临床合理用药提供参考。方法对某医院2015年1月—2015年9月外科住院患者感染病原菌的构成及耐药情况进行统计分析。结果送检的1587份临床标本共分离出471株病原菌,其中大肠埃希菌(25.9%)、金黄色葡萄球菌(19.5%)、肺炎克雷伯菌(8.5%)、铜绿假单胞菌(6.8%)和凝固酶阴性葡萄球菌(5.3%)的分离率居前5位。大肠埃希菌和肺炎克雷伯菌对亚胺培南100.0%敏感,对阿米卡星、头孢替坦、哌拉西林/三唑巴坦、阿莫西林/克拉维酸的耐药率<15.0%,对氨苄西林、头孢噻吩、哌拉西林、头孢唑啉的耐药率较高;铜绿假单胞菌对多黏菌素的耐药率最低,对氨苄西林、头孢唑啉、头孢曲松、头孢替坦、复方磺胺甲噁唑、呋喃妥因100.0%耐药。金黄色葡萄球菌和凝固酶阴性葡萄球菌对青霉素、红霉素的耐药率高,对万古霉素、利奈唑胺、替加环素100.0%敏感;耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率为50.0%、81.6%;肠球菌对红霉素、克林霉素、四环素、高浓度庆大霉素的耐药率>60.0%。结论该医院外科患者感染病原菌以革兰阴性杆菌为主,不同病原菌对抗菌药物的耐药性不同,临床应根据患者感染病原菌特点及体外药敏实验结果合理用药治疗。Objective To research distribution and drug resistance of pathogens from surgical inpatients, so that we can provide a reference for clinical rational drug therapy. Methods To analyze the composition and drug resistance of pathogens in surgical hospitalized patients from January 2015 to September 2015. Results 471 pathogens were isolated from the 1587 clinical specimens, and the top five pathogens were Escherichia coli（25.9%）, Staphylococcus aureus（19.5 % ）, Klebsiella pneumoniae（ 8.5 % ）, Pseudomonas aeruginosa（ 6.8% ） and Coagulase negative staphylococci（5.3%）. Escherichia coli and Klebsiella pneumoniae were both 100.0% sensitive to Imipenem, also, to Amikacin, Cefotetan, Piperacillin/Tazobactam and Amoxicillin/Clavulanicacid, the resistant rate was less than 15.0%. While to Ampicillin, Cephalothin, Piperacillin and Cefazolin the resistant rate were high. The resistance rate of Pseudomonas aeruginosa to Polymyxin was the lowest, but to Ampicllin, Cefazolin, Ceftriaxone, Cefotetan, Cotrimoxazole and Nitrofurantoin were 100.0%. Constituent ratio of MRSA, MRCNS in Staphylococcus aureus and Coagulase negative Staphylococcus was 50%, 81.6%. The drug susceptibility rates of Staphylococcus aureus and Coagulase-negative staphylococci to Vancomycin, Linezolid and Tigecycline were 100.0%, but resistancerate to Penicillin, Erythromycin were high. The resistant rates of the Enterococcus to Erythromycin, Clindamycin, Tetracycline, and high concentrations of Gentamicin were more than 60.0%. Conclusions The main pathogen infecting surgical inpatients was Gram-negative bacilli. The resistance rates of different pathogens to antimicrobial drug was different. So it is necessary for clinical work to use drug therapy rationally based on the characteristics of pathogens infecting patients and the results of drug susceptibility test.

关 键 词：外科患者 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]