急性脑梗死患者医院感染病原菌及耐药性分析  

Analysis on the distribution and drug resistance of pathogens of nosocomial infections in patients with acute cerebral infarction in emergency department

作　　者：付晶[1] 王一凡[1] 施阳[1] 许海东 代正[2] 苏明华[2] FU Jing;WANG Yi-fan;SHI Yang;XU Hai-dong;DAI Zheng;SU Ming-hua(Sichuan Provincial People＇s Hospital,Chengdu,Sichuan 610072,China)

机构地区：[1]四川省人民医院急诊内科,四川成都610072 [2]四川省人民医院急诊监护室,四川成都610072

出　　处：《中华医院感染学杂志》2018年第19期2917-2920,共4页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅基金资助项目(17PJ130)

摘　　要：目的分析急诊急性脑梗死(ACI)患者医院感染病原菌及耐药性。方法选取2016年6月-2017年6月医院急诊科收治的ACI合并医院感染患者62例作为研究对象。采集患者的感染相关样本,对其病原菌分布及耐药性进行检测和分析。结果急诊ACI合并医院感染患者以肺部和泌尿系统感染为主,共培养分离病原菌88株,其中革兰阴性菌62株占70.45%,以大肠埃希菌和铜绿假单胞菌为主;革兰阳性菌19株占21.59%,以金黄色葡萄球菌为主;真菌7株占7.95%;主要革兰阴性菌对氨苄西林、头孢噻肟、庆大霉素的耐药性较高,对亚胺培南、阿米卡星较敏感,检出2株耐亚胺培南铜绿假单胞菌和1株耐亚胺培南鲍氏不动杆菌;主要革兰阳性菌对红霉素、庆大霉素、环丙沙星、氨苄西林的耐药率较高,对替考拉宁、利奈唑胺较敏感,未检出对万古霉素耐药的菌株。结论急诊ACI患者医院感染的病原菌以革兰阴性菌为主,且耐药性较高,存在一定的多药耐药现象,临床应给予严密的监测并选用敏感性抗菌药物进行抗感染治疗。OBJECTIVE To analyze the distribution and drug resistance of pathogens of nosocomial infections in patients with acute cerebral infarction（ACI）in emergency department.METHODS 62 cases of patients with ACI complicated with nosocomial infections in emergency department from Jun.2016 to Jun.2017 were selected as the research objects.The infection related samples were collected and the distribution as well as the drug resistance of the pathogens were detected and analyzed.RESULTS The main types of nosocomial infections in the patients with ACI in emergency department were pulmonary infections and urinary tract infections.88 strains of pathogens were isolated,among them,62 strains were gram-negative bacteria accounting for 70.45%,which were mainly Escherichia coli and Pseudomonas aeruginosa.19 strains were gram-positive bacteria accounting for 21.59%,which were mainly Staphylococcus aureus.7 strains were fungi accounting for 7.95%.The drug resistance rates of gram-negative bacteria to ampicillin,cefotaxime cefotaxime,gentamicin were relatively high,whereas the drug resistance rates to imipenem or amikacin were relatively low.2 strains of P.aeruginosa resistant to imipenem and 1 strain of Acinetobacter baumannii resistant to imipenem were detected.The drug resistance rates of gram-positive bacteria to erythromycin,gentamicin,ciprofloxacin,ampicillin were relatively high,whereas the drug resistance rates to teicoplanin or linezolid were relatively low.No vancomycin-resistant strain was detected.CONCLUSIONThe distribution of pathogens of nosocomial infections in patients with ACI was dominated by gram-negative bacteria.Their drug resistance was relatively high,with multidrug resistance.The clinicians should give strict monitoring and select sensitive antibiotics for anti-infection treatments.

关 键 词：急诊 急性脑梗死 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]