神经内科299株病原菌的临床分布及耐药性分析  

Distribution and Drug Resistance Analysis of Pathogens from 299 Strains in Department of Neurology

作　　者：杨文伟[1] 蒋良芝 李春燕 吴亚洲[1] 戴月[1] YANG Wen-wei;JIANG Liang-zhi;LI Chun-yan(Yangpu Central Hospital,Shanghai 200090,China)

机构地区：[1]上海杨浦区中心医院,上海200090

出　　处：《吉林医学》2019年第2期253-256,共4页Jilin Medical Journal

摘　　要：目的:分析某院神经内科临床分离菌对常用抗菌药物的敏感性和耐药性,为临床抗感染治疗和预防耐药菌的产生提供理论依据。方法:采用纸片扩散法或自动化仪器法对神经内科近两年的临床分离菌进行药敏试验,并按美国临床和实验室标准化协会(CLSI) 2016版标准对结果进行判断;用WHONET5. 6进行数据分析。结果:共299株病原菌,其中革兰阳性菌106株,占35. 5%;革兰阴性菌193株,占64. 5%。前5位病原菌依次是大肠埃希菌(27. 76%)、金黄色葡萄球菌(12. 71%)、肺炎克雷伯菌(9. 70%)、凝固酶阴性葡萄球菌(Co NS)(9. 70%)、铜绿假单胞菌(9. 03%)。送检标本细菌分离率由高到低依次为尿液42. 47%(127/299)、呼吸道标本40. 13%(120/299)、血标本13. 04%(39/299)。MRSA检出率76. 3%,MRCNS检出率75. 9%,屎肠球菌中VRE检出率12. 5%,大肠埃希菌和克雷伯菌属中ESBLs的检出率分别为49. 4%和17. 2%,肠杆菌科细菌中CRE菌株的检出率0. 8%,肺炎克雷伯菌中XDR菌株的检出率为3. 4%,鲍曼不动杆菌中XDR菌株的检出率为31. 2%,铜绿假单胞菌中XDR株检出率为3. 7%。结论:神经内科住院患者的病情重,治疗难,要合理选择抗生素,防止抗生素不合理使用导致的耐药菌株的出现。Objective The purpose of our study is to analyze the sensitivity of pathogens and drug resistance separated from department of neurology,and it is useful to provide the theory basis for clinical anti-infection treatment and to prevent the production of resistant bacteria.Method Kirby-Bauer method and automation instrument method were be used to do drug sensitivity test for pathogens separated from department of neurology,and the results were judged according to the clinical and laboratory standards institute(CLSI)2016.Results Totally 299 strains of pathogens had been isolated,including 106(35.5%)strains of gram-positive bacteria and 193(64.5%)gram-negative bacteria.The Top five pathogens were E.coli(27.76%),staphylococcus aureus(12.71%),klebsiella pneumoniae(9.70%),coagulase negative staphylococcus(CoNS)(9.70%)and pseudomonas aeruginosa(9.03%).The separation rate from high to low were:urine 42.47%(127/299),respiratory specimens 40.13%(120/299)and blood specimens 13.04%(39/299).The detection rates of MRSA,MRCNS and VRE in enterococcus faecium were 76.3%,75.9%and 12.5%,respectively.The detection rate of ESBLs in E.coli and klebsiella were 49.4%and 17.2%,respectively.The detection rate of CRE in Enterobacter was 0.8%,and the detection rate of XDR in klebsiella pneumonia,acinetobacter baumannii and pseudomonas aeruginosa was 3.4%,31.2%and 3.7%,respectively.Conclusion The condition was serious and the treatment of the patients was difficult in department of neurology,we should choose the reasonable antibiotics and prevent the emergence of resistant strains which caused by irrational use of antibiotics.

关 键 词：神经内科 病原菌 耐药菌 抗生素 

分 类 号：R446.5[医药卫生—诊断学]