神经外科院内感染病原菌耐药监测分析  

Drug resistance monitoring and system analysis of pathogen in neurosurgery with nosocomial infection

作　　者：王策[1] 王盼[1] 李淑霞[1] 李艳华[1] 张慧慧 王彩虹 WANG Ce, WANG Pan, LI Shu-xia, LI Yan-hua ,ZHANG Hui-hui, WANG Cai-hong(The First Hospital of Yulin,Yulin 719000, Chin)

机构地区：[1]榆林市第一医院,陕西榆林719000

出　　处：《延安大学学报（医学科学版）》2018年第1期64-67,共4页Journal of Yan'an University:Medical Science Edition

基　　金：榆林市2016年社会发展基金项目

摘　　要：目的分析神经外科院内感染病原菌分布特征及其耐药性,以期临床采取针对性预防措施,为抗菌药物治疗提供理论依据。方法选取榆林市两所三级甲等医院神经外科所有病原菌,对其药敏试验结果及其耐药性进行分析。结果分离的前4位病原菌分别为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌;鲍曼不动杆菌除对多肽类、四环素类药物较敏感外,对其他抗菌代表药耐药率均大于60.0%;肺炎克雷伯菌对广谱青霉素类耐药率为84.6%;大肠埃希菌对二代头孢类药物耐药率最高,为73.3%;肺炎克雷伯菌、大肠埃希菌中产ESBLs菌株所占比例分别为37.0%、62.2%,二者碳青霉烯类耐药率分别为4.1%、4.4%。结论神经外科患者院内感染主要病原菌为非发酵菌和肠杆菌,建议神经外科病房应多消毒,对患者加强护理,合理使用抗生素,减少介入性操作。Objective The distribution characteristics and drug resistance of pathogen were analyzed in neurosurgery with nosocomial infection. It provided scientific basis for taking precaution and antibiotic therapy in clinic. Methods Drug-sensitivity test and resistance of pathogens were analyzed retrospectively in neurosurgery of two top hospitals of Yulin city. Results The first four pathogens were Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii,which were separated respectively. Acinetobacter baumannii was more sensitive to peptides and tetracyclines than to other antimicrobial agents. Klebsiella pneumoniae resistant rate to a wide spectrum of penicillins was 84. 6% . Escherichia coli was the most resistant to the second-generation cephalosporins,which was 73. 3% . The proportion of ESBLs-producing bacteria in Klebsiella pneumoniae and Escherichia coli were 37. 0% and 62. 2% ,and the carbapenem resistance rates were 4. 1% and 4. 4% ,respectively. Conclusion The main pathogens for nosocomial infections in neurosurgical patients are non-fermentative bacteria and Enterobacteriaceae. It is recommended that neurosurgery wards should be disinfected more,and patients should be given more care,use antibiotics rationally,and reduce interventional procedures.

关 键 词：院内感染 病原菌 耐药性 多重耐药菌 

分 类 号：R446.5[医药卫生—诊断学]