江西省某三甲医院2016-2021年神经外科病原菌分布及耐药性分析  

Analysis on Distribution and Drug Resistance of Pathogens in Department of Neurosurgery of a Grade Ⅲ Level A Hospital in Jiangxi Province,2016-2021

作　　者：李露[1,2] 李敏华 王丽梅[1] 罗倩 喻鹏[1] 张翀旎 LI Lu;LI Min-hua;WANG Li-mei;LUO Qian;YU Peng;ZHANG Zhong-ni(School of Nursing,the First Affiliated Hospital,Nanchang University,Nanchang 330006,China;Department of Medical Social Work,the First Affiliated Hospital,Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学护理学院,南昌330006 [2]南昌大学第一附属医院医务社工部,南昌330006

出　　处：《实用临床医学（江西）》2023年第5期105-109,共5页Practical Clinical Medicine

基　　金：江西省卫健委科技项目(SKJP220229887)。

摘　　要：目的研究江西省某三甲医院2016—2021年神经外科常见病原菌分布特点及耐药性,为临床神经外科抗感染治疗提供依据。方法回顾性分析江西省某三甲医院2016—2021年神经外科送检标本的微生物培养结果,用WHONET5.6软件进行统计分析。结果2016—2021年南昌大学第一附属医院神经外科共分离8975株病原菌,革兰氏阴性菌占81.9%,其中以肺炎克雷伯杆菌、鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌为主;革兰氏阳性菌占18.1%,其中以金黄色葡萄球菌、凝固酶切阴性葡萄球菌、屎肠球菌为主。检出菌株主要分离自呼吸道痰液标本(78.5%),从病区分布看,检出菌株主要来自于神经外科重症监护病房(NICU),占比58.6%。耐药性检测结果显示:革兰氏阴性菌对氨苄西林耐药率较高(>85%),对替加环素、多黏菌素B敏感性较高(>90%);革兰氏阳性菌对青霉素G、氨苄西林耐药率较高(>85%),对奎奴普丁/达福普汀、利奈唑胺、万古霉素、替加环素保持较好的敏感性(>90%)。表达超广谱β内酰胺酶(ESBLs)的肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌及大肠埃希菌的检出率分别为56.9%、82.7%、95.9%、63.1%,耐碳青霉烯类抗生素的肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌及大肠埃希菌的检出率依次为49.9%、85.1%、38.9%、18.1%,对苯唑西林耐药的金黄色葡萄球菌和凝固酶切阴性葡萄球菌检出率分别为37.4%和77.7%。结论神经外科病原菌耐药情况较为严峻,需加强细菌耐药性监测,根据药敏结果为患者制定合理的抗感染方案并加强院内感染防控。Objective To analyze the distribution characteristics and drug resistance of common pathogens in the department of neurosurgery of a gradeⅢlevel A hospital in Jiangxi Province from 2016 to 2021,and to provide evidence for clinical anti-infection treatment.Methods A retrospective analysis was conducted on the microbiological culture results of neurosurgery specimens from 2016 to 2021 in a gradeⅢlevel A hospital in Jiangxi Province.The statistical analysis was performed using WHONET 5.6 software.Results From 2016 to 2021,a total of 8975 strains of pathogenic bacteria were isolated from the department of neurosurgery of our hospital.Among them,Gram-negative bacteria accounted for 81.9%(mainly including Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa and Escherichia coli),and Gram-positive bacteria accounted for 18.1%(mainly including Staphylococcus aureus,coagulase-negative Staphylococcus and Enterococcus faecium).The pathogenic bacteria were mainly from neurosurgical intensive care unit(58.6%),and mainly isolated from sputum specimens(78.5%).The results of drug resistance testing showed that Gram-negative bacteria were highly resistant to ampicillin(>85%)and highly sensitive to tigecycline and polymyxin B(>90%).Gram-positive bacteria had a high resistance rate to penicillin G and ampicillin(>85%),and maintained a good sensitivity to quinupristin/dalfopristin,linezolid,vancomycin and tigecycline(>90%).The detection rates of extended-spectrum beta-lactamases(ESBLs)-producing Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa and Escherichia coli were 56.9%,82.7%,95.9%and 63.1%,respectively.The detection rates of carbapenem-resistant Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa and Escherichia coli were 49.9%,85.1%,38.9%,and 18.1%,respectively.The detection rates of oxacillin-resistant Staphylococcus aureus and coagulase-negative Staphylococcus were 37.4%and 77.7%,respectively.Conclusion The drug resistance of pathogens in department of neurosurgery is

关 键 词：神经外科 病原菌 耐药性分析 医院感染 

分 类 号：R446.5[医药卫生—诊断学]