摘要
目的了解医院外科感染常见病原菌的分布及其耐药性,为外科院内感染合理选用抗生素提供参考。方法收集医院外科2013年8月~2015年8月住院且发生感染的患者210例,分离培养并鉴定细菌,采用K-B纸片法进行药敏试验,对病原菌的来源、分布及耐药情况进行统计分析。结果210例患者中发生医院感染32例,感染率为15.23%;共检出病原菌65株,以革兰阴性菌为主,占58.46%（38/65）,其中大肠埃希菌占27.69%,铜绿假单胞菌占9.23%,肺炎克雷伯菌占6.15%;检出革兰阳性菌23株,占35.38%,,其中金黄色葡萄球菌占16.92%,表皮葡萄球菌、肠球菌及溶血性链球菌分别占7.69%、6.15%和3.08%;大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌属产ESBLs株分别为10、3和2株,各占相应菌株的55.56%、50.00%和50.00%,未检出对亚胺培南耐药的产ESBLs株;检出MRSA7株,占金黄色葡萄球菌的45.45%,该菌对万古霉素和呋喃妥因的敏感率均为100.00%。检出真菌4株,占6.15%,以白色念珠菌为主。结论医院外科感染以革兰阴性菌为主,该类菌对亚胺培南敏感。医院外科感染及多重耐药情况严重,应作病原菌的分离及药敏试验,合理选用抗菌药物进行抗感染治疗。
Objectives To ascertain the distribution and drug resistance of common pathogenic bacteria in nosocomial infections and to provide a reference for rational use of antibiotics in surgery at this Hospital. Methods Samples were collected from 210 patients who developed an infection while in hospital from August 2013 to August 2015,and the pathogens causing that infection were isolated,cultured,and identified.The pathogens were subjected to a drug sensitivity test using the K-B method,and the distribution and drug resistance of pathogens were analyzed.Results Of the 210 patients,32had a nosocomial infection,for a rate of infection of 15.23%.Sixty-five strains of pathogens were detected.The most prevalent pathogens were Gram-negative bacteria,which accounted for 58.46%（38/65）of the identified strains.Of the strains of Gram-negative bacteria,27.69% were Escherichia coli,9.23% were Pseudomonas aeruginosa,and 6.15%were Klebsiella pneumoniae.Of the 65 strains of pathogens,23 were strains of Gram-positive bacteria,accounting for35.38% of the identified strains.Of these strains,16.92% were Staphylococcus aureus,7.69% were Staphylococcus epidermidis,6.15% were Enterococcus spp,and 3.08% were Streptococcus hemolyticus.Ten（55.56%）of the E.coli strains,3（50.00%）of the P.aeruginosastrains,and 2（50.00%）of the Klebsiella pneumoniae produced ESBLs.No ESBL-producing strains were found to be resistant to imipenem.Seven strains of MRSA were detected,accounting for45.45% of the S.aureus strains identified.The sensitivity of this bacterium to vancomycin and nitrofurantoin was 100.00%.Four strains（6.15%）of fungi were detected,and these strains were mainly Candida albicans. Conclusion Nosocomial infections were primarily caused by Gram-negative bacteria,which were sensitive to imipenem.This Hospital has a serious incidence of surgical infections and bacteria with serious multidrug-resistance.Pathogenic bacteria should be isolated and a drug sensitivity test should be performed as soon as possible.Antibiotics should be used rationally in accordance with those results in order to treat infections.
出处
《中国病原生物学杂志》
CSCD
北大核心
2016年第8期750-753,756,共5页
Journal of Pathogen Biology
关键词
外科
医院感染
病原菌分布
耐药性
Surgery
nosocomial infection
distribution of pathogenic bacteria
drug resistance
