胸外科患者术后医院感染病原学特点及药敏分析  

Etiological characteristics and drug sensitivity analysis of nosocomial infections after department of thoracic surgery

作　　者：张士法 李迎新 蔡海波 高国栋 孙波 高连方 ZHANG Shi-fa;LI Ying-xin;CAI Hai-bo;GAO Guo-dong;SUN Bo;GAO Lian-fang(Jining First People＇s Hospital, Jining, Shandong 272000, Chin)

机构地区：[1]济宁第一人民医院胸外科,山东济宁272000

出　　处：《中华医院感染学杂志》2018年第3期410-413,共4页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(2014ZRA08013)

摘　　要：目的研究胸外科术后患者医院感染病症与病原学特点及药物敏感分析。方法回顾性分析2013年12月-2016年12月于医院接受胸部外科手术患者864例,统计患者手术后的医院感染情况及感染部位,对感染部分的病原菌分布及其药敏试验状况进行分析。结果 864例患者中发生医院感染有127例,感染率14.70%,但其感染情况呈逐年降低趋势(P<0.05),感染部位以呼吸系统为主;检测患者标本共685份,其中192份为阳性标本,阳性率为28.03%,其中革兰阴性菌共134株占69.79%,以铜绿假单胞菌为主;革兰阳性菌共44株占22.92%,以金黄色葡萄球菌为主;真菌共14株占7.29%。药敏结果显示,铜绿假单胞菌对美罗培南、头孢他啶、亚胺培南、他唑巴坦、头孢吡肟及头孢哌酮/舒巴坦耐药率均高于80.00%,肺炎克雷伯菌对美罗培南、亚胺培南耐药率达100.00%,对阿米卡星、他唑巴坦及头孢哌酮/舒巴坦耐药率高于80.00%,大肠埃希菌对环丙沙星、左氧氟沙星及头孢噻圬耐药率高于60.00%,金黄色葡萄球菌对万古霉素耐药率达100.00%,对环丙沙星、左氧氟沙星耐药率高于60.00%。结论及时了解胸外科患者术后医院感染情况、常用抗菌药物耐药性和病原菌分布,从而选取合适抗菌药物,可有效预防控制患者术后医院感染率。OBJECTIVE To investigate the etiological characteristics and drug sensitivity of nosocomial infections in patients with thoracic surgery. METHODS A retrospective analysis of 864 patients undergoing thoracic surgery in our hospital from Dec. 2013 to Dec. 2016 was carried out. The distribution of pathogenic bacteria and the drug sen- sitivity test of the infected parts were analyzed.RESULTS In 864 cases of patients, nosocomial infections occurred in 127 cases, the infection rate was 14.70%, but the infections decreased year by year（P〈0.05）. The infection site was mainly respiratory system. Totally 192 specimens were positive of 685 detected cases, and the positive rate was 28.03%, of which there were 134 strains of gram-negative bacteria accounting for 69.79%, mainly Pseudomonas aeruginosa, 44 strains of gram-positive bacteria accounting for 22.92%, mainly Staphylococcus au- reus, and 14 strains of fungi, accounting for 7.29%. Drug susceptibility results showed that resistant rates of Pseudomonas aeruginosa to meropenem, ceftazidime and tazobactam, imipenem, cefepime and eefoperazone/sul- bactam were higher than 80.00%, resistant rates of Klebsiella pneumoniae to meropenem and imipenem were 100.00%, and to amikacin, tazobactam and cefoperazone/sulhactam were higher than 80.00%, resistant rates of Escherichia coli to ciprofloxacin, levofloxaein and cefotaxime were higher than 60.00%, and resistant rate of Staphylococcus aureus to vancomycin was 100.00%, and to ciprofloxacin and levofloxacin were higher than 60.00 %.CONCLUSION In order to prevent and control the incidence of nosocomial infections, it is necessary to know the clinical situation of nosocomial infections, the antibiotic resistance and the distribution of pathogenicbacteria in department of thoracic surgery.

关 键 词：胸外科手术 医院感染 病原菌 抗菌药物耐药性 

分 类 号：R378[医药卫生—病原生物学]