神经内科院内感染病原菌分布及耐药性分析  

Analyses of distribution and drug resistance of nosocomial infection pathogens in patients in neurology department

作　　者：邱波 台桦 张东军[3] QIU Bo;TAI Hua;ZHANG Dong-jun(Neurology Department,Central People's Hospital of Tengzhou City,Shandong Province,Tengzhou 277599,Shandong,China)

机构地区：[1]山东省滕州市中心人民医院神经内科,山东滕州277599 [2]山东省济宁市卫生学校 [3]山东省寄生虫病防治研究所/山东第一医科大学(山东省医学科学院)

出　　处：《中国校医》2020年第7期487-489,513,共4页Chinese Journal of School Doctor

基　　金：山东省医学科学院科研基金面上项目(2018-04);徐州发明协会科技成果培育项目(XAI201805)。

摘　　要：目的分析神经内科患者医院感染病原菌分布及耐药性,为合理选择临床抗菌药物提供依据。方法选取2016年5月-2019年5月滕州市中心人民医院神经内科院内感染患者202例,按照《全国临床检验操作规程》标准分离、鉴定细菌,用K-B纸片法进行药敏试验,统计医院感染情况,并对分离病原菌的分布及耐药情况进行回顾性分析。结果神经内科院内感染以下呼吸道感染为主,占33.17%,其次为泌尿道和消化系统感染,占比为21.29%和13.86%;共分离病原菌268株,其中革兰阴性菌112株,占41.79%;真菌103株,占38.43%;革兰阳性菌53株,占19.78%。革兰阴性杆菌中大肠埃希菌对亚胺培南、头孢哌酮舒巴坦耐药率低于<15%,对哌拉西林和头孢噻肟耐药率>65%;产ESBLs肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌检出率为分别为37.50%、34.62%、38.10%;金黄色葡萄球菌对阿莫西林耐药率为91.30%,革兰阳性球菌对利奈唑胺、万古霉素敏感。结论神经内科院内感染分离病原菌以革兰阴性菌为主,对常用的抗菌药物耐药率高,应合理选用抗菌药物。Objective To Analyze the distribution and drug resistance of nosocomial pathogens in the patients in neurology department so as to provide the evidence for the rational selection of clinical antibacterial drugs.Methods A total of 202 nosocomial infected patient specimens from the Department of Neurology of the People’s Hospital of Tengzhou City Center were collected and detected to isolate and identify the bacteria according to the standards of the "National Clinical Inspection Operating Procedures from May 2016 to May 2019.The drug resistance was tested by the K-B paper disk method.The status of nosocomial infections was statistically analyzed,and the distribution of pathogens and the drug resistance status were retrospectively analyzed.Results The main nosocomial infection in the patients in neurology department was lower respiratory infection(33.17%) and then was urinary tract infection(21.29%) and digestive system infection(13.86%).A total of 268 bacterial strains were isolated including Gram-negative bacterium(112 strains,41.79%),fungus(103 strains,38.43%),and Gram-positive bacterium(53 strains,19.78%).Among the Gram-negative bacterium,Escherichia coli was more sensitive to imipenem and cefoperazone sulbactam and more resistant to piperacillin and cefotaxime;The detection rates of ESBLs+Klebsiella pneumoniae,Pseudomonas aeruginosa,and Escherichia coli were 37.50%,34.62%(9/26) and 38.10%respectively.The resistance rate of Staphylococcus aureus to amoxicillin was 91.30%. Gram-positive cocci were sensitive to linezolid and vancomycin.Conclusion The pathogenic bacteria from the nosocomial infection of the patients in neurology department are mainly Gram-negative bacteria,and they have a high rate of resistance to commonly used antibacterial drugs,so we should rationally select the antibacterial drugs.

关 键 词：医院感染病原菌 耐药检测 合理用药 

分 类 号：R446.5[医药卫生—诊断学]