颅脑手术后医院获得性肺炎病原菌分布及耐药性分析  

Distribution and Drug Resistance of Nosocomial Pneumonia Pathogens After Craniocerebral Surgery

作　　者：穆怀博[1] 宋超[1] MU Huaibo;SONG Chao(Chengde Central Hospital, Hebei Chengde067000,China)

机构地区：[1]河北省承德市中心医院,河北承德067000

出　　处：《河北医学》2020年第8期1352-1357,共6页Hebei Medicine

摘　　要：目的:了解颅脑手术后医院获得性肺炎(HAP)病原菌分布及耐药性,为临床抗感染经验治疗提供依据。方法:回顾性分析2018年1月至2018年8月神经外科颅脑手术后60例肺炎患者送检的痰标本所分离的致病菌及其耐药性。结果:共检出病原菌185株,其中革兰氏阴性菌165株占89.19%,革兰氏阳性菌18株占9.73%,真菌2株占1.08%。检出率排在前5位的病原菌依次为铜绿假单胞菌57株占30.81%,肺炎克雷伯菌32株占17.30%,鲍曼不动杆菌27株占14.59%,大肠埃希菌25株占13.51%,液化沙雷菌12株占6.49%;铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、液化沙雷菌对亚胺培南、美罗培南、头孢哌酮舒巴坦、哌拉西林他唑巴坦、阿米卡星、环丙沙星及头孢吡肟有较好敏感性,鲍曼不动杆菌只对头孢哌酮舒巴坦有较好敏感性,其他药物均耐药;金黄色葡萄球菌未发现万古霉素耐药株,并对多西环素、米诺环素有良好敏感性。结论:颅脑手术后HAP病原菌以革兰阴性杆菌为主,并部分呈多药耐药性。Objective:To understand pathogens distribution and drug resistance of HAP after craniocerebral operation,and to provide evidence for clinical anti-infection empirical treatment.Methods:A retrospective analysis was conducted on the bacteria and their drug-resistance of urinarytract infections isolated from the sputum specimens of 60 pneumonia patients from January 2018to August 2018 after their intracranial surgery.Results:185 strains of pathogens were found,including 165 strains of gram negative bacteria,accounting for 89.19%,gram positive bacteria,18 strains,accounting for 9.73%and 2 strains of fungi,accounting for 1.08%.The detection rate of the top five pathogens were 57 strains of Pseudomonas aeruginosa,accounting for 30.81%,32 strains of Klebsiella pneumonia,accounting for 17.3%,Bauman 27 Acinetobacter strains,accounting for 14.59%,25 strains of Escherichia coli,accounting for 13.51%,and 12 strains of Serratia liquefaciens,accounting for 6.49%.Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Serratia liquefaction have better sensitivity to imipenem,meropenem,cefoperazone sulbactam,piperacillin tazobactam,amikacin,ciprofloxacin and cefepime.Acinetobacter baumannii only has good sensitivity to cefoperazone sulbactam,and has resistance to other drugs.Vancomycin-resistant strains of Staphylococcus aureus was not found,and it has a good sensitivity to doxycycline and minocycline.Conclusion:After craniocerebral operation,most common infection microorganism of HAP was Gram-negative bacteria,and parts showed multidrug resistance.

关 键 词：颅脑手术 医院获得性肺炎 病原菌 耐药性 

分 类 号：R44[医药卫生—诊断学]