摘要
目的探讨外科住院患者医院感染的主要病原菌种类及其敏感药物,为降低医院感染的发生率提供依据,指导临床合理用药。方法回顾性分析87例外科住院并发生医院感染患者的病原菌种类及其药物敏感试验结果。结果87例患者分离培养出病原菌90株,各病原菌构成比依次为:大肠埃希菌34.45%、铜绿假单胞菌20%、肺炎克雷伯菌11.11%、鲍曼不动杆菌3.33%、奇异变形杆菌2.22%、金黄色葡萄球菌14.45%、粪肠球菌D群2.22%和真菌12.22%。大肠埃希菌产β-内酰胺酶(extended-spectrum β-lactamases,ESBLs)菌株占77.42%,对亚胺培南100%敏感,哌拉西林/他唑巴坦、呋喃妥因敏感性较高,其他抗菌药物耐药率均>60.0%。铜绿假单胞菌对头孢唑林、头孢曲松100.0%耐药,对氨曲南、复方新诺明耐药率较高。肺炎克雷伯菌产ESBLs菌株占10.0%,对亚胺培南、呋喃妥因、头孢吡肟较敏感。金黄色葡萄球菌对青霉素100%耐药,对万古霉素、利奈唑烷、呋喃妥因等较敏感。结论外科住院患者易感染大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌等,它们对亚胺培南和万古霉素敏感,但对其他抗生素耐药性严重,临床应根据药敏试验结果合理使用抗生素,减少外科医院感染的发生和耐药菌株的产生具有重要的意义。
Objective To know the pathogenic species of hospital infection in surgical ward and their sensitive antibiotics and to provide scientific evidences to decrease the hospital infection rates and guide rational clinical therapy.Methods Eighty-seven patients with hospital infection in surgical ward were analyzed retrospectively for pathogenic species and drug resistance test results.Results A total of 90 strains were isolated from the 87 patients,and the constitute ratios were 34.45% in Escherichia Coli,20% in Pseudomonas Aeruginosa,11.11% in Klebsiella pneumonia,3.33% in Acinetobacter baumannii,2.22% in Proteus mirabilis.14.45% in Staphylococcus Aureus,2.22% in Enterococcus faecalis D group and fungi in 12.22%.77.42% of the isolated Escherichia Coli strains produced extended-spectrum β-lactamases（ESBLs）,which were sensitive to imipenem,piperacillin,furadantin,and the drug resistance rates of which were above 60.0%.Pseudomonas aeruginosa were resistant to cefazolin,ceftriaxone,aztreonam and trimethoprim-sulfamethoxazole.10% of Klebsiella pneumonia strains produced ESBLs,which were sensitive to imipenem,furadantin and cefepime.The Staphylococcus aureus were resistant to vancocin,linezolid and furadantin.Conclusion The patients in surgical ward are infected by Pseudomonas Aeruginosa,Klebsiella pneumonia,Acinetobacter baumannii and Proteus mirabilis,which are sensitive to imipenem and vancocin but resistant to other antibiotic severely.The antibiotics should be used reasonably according to drug sensitive test.This will be very important to decrease the presence of hospital infection and drug resistance.
出处
《医学综述》
2008年第11期1744-1746,共3页
Medical Recapitulate
关键词
医院感染
病原菌
耐药性
Hospital infection
Pathogens
Drug resistance
