住院精神病病例呼吸道医院感染咽部定植菌群改变及耐药性  

Changes and drug resistance of pharyngeal colonized flora of respiratory tract nosocomial infection in hospitalized psychiatric cases

作　　者：周彦[1] 朱梦雅 李婴慧 孙雅君 郝苏怡 陈雪菲[2] ZHOU Yan;ZHU Mengya;LI Yinghui;SUN Yajun;HAO Suyi;CHEN Xuefei(Department of Infection Management,Huai'an Third People's Hospital,Huai'an,Jiangsu 223001,China;不详)

机构地区：[1]淮安市第三人民医院感染管理科,江苏淮安223001 [2]淮安市第三人民医院检验科

出　　处：《医学动物防制》2025年第4期408-411,共4页Journal of Medical Pest Control

基　　金：江苏省科技计划项目(LZ11235)。

摘　　要：目的探讨某医院住院精神病病例呼吸道医院感染的咽部定植菌检出情况及耐药性,为住院病例呼吸道感染防治提供依据。方法将某医院2019年1月至2023年1月收治的200例住院精神病病例纳入研究,依据病原菌定植情况分为病例组(n=78)和正常组(n=122)。分析病例呼吸道医院感染情况及病原菌种类;观察不同住院时期精神病病例咽部主要定植菌的变化和耐药率,率的比较采用χ^(2)检验。结果病例组两种及以上病原菌定植病例呼吸道医院感染例数显著高于一种病原菌定植病例数(χ^(2)=6.545,P=0.011);2019—2023年住院精神病病例的病原菌检出率逐年上升,占比前5位的病原菌分别为克雷伯菌、金黄色葡萄球菌、大肠埃希菌、乙型溶血性链球菌、奈瑟菌;克雷伯菌和金黄色葡糖球菌在住院精神病病例入院第1d的分离率显著高于其他病原菌(χ^(2)=9.042、7.521,P<0.05);革兰阴性菌对亚胺培南、阿米卡星敏感性较好,革兰阳性菌对呋喃妥因敏感性较好,对万古霉素保持100%敏感。结论住院精神病病例呼吸道医院感染病原菌检出率逐年上升,具有较高耐药性,临床应用价值高。Objective To investigate the detection and drug resistance of pharyngeal colonized bacteria in respiratory tract nosocomial infection of psychiatric cases in a hospital,and to provide evidence for the prevention and treatment of respiratory tract infection.Methods A total of 200 hospitalized psychiatric cases admitted to a hospital from January 2019 to January 2023 were included in the study and divided into a case group(n=78)and a normal group(n=122)according to pathogen colonization.The nosocomial infection of the respiratory tract and species of pathogenic bacteria were analyzed.The changes of major colonized bacteria in the pharynx and drug resistance rate of major colonized bacteria were observed in psychiatric cases at different periods of hospitalization,and the rates were compared using the Chi-square test.Results The number of respiratory tract nosocomial infections in cases colonized by two or more pathogenic bacteria in the case group was significantly higher than that of cases colonized by one pathogen(χ^(2)=6.545,P=0.011).From 2019 to 2023,the detection rates of pathogenic bacteria in hospitalized psychiatric cases increased year by year,with the top 5 pathogenic bacteria were Klebsiella,Staphylococcus aureus,Escherichia coli,beta-hemolytic Streptococcus,and Neisseria.The isolation rates of Klebsiella and Staphylococcus aureus in hospitalized psychiatric cases on the first day of admission were significantly higher than those of other pathogenic bacteria(χ^(2)=9.042,7.521,P<0.05).Gram-negative bacteria were more sensitive to imipenem and amikacin,and Gram-positive bacteria were more sensitive to furantoin and remained 100%sensitive to vancomycin.Conclusion The detection rates of pathogenic bacteria in cases with respiratory tract nosocomial infection in hospitalized psychiatric cases are increasing year by year and have high drug resistance,which is of high clinical application value.

关 键 词：精神病病例 呼吸道医院感染 咽部 定植菌群 耐药性 

分 类 号：R446.5[医药卫生—诊断学]