医院人员咽部机会致病菌与岗位相关性的研究

Correlation of Pharyngeal Opportunistic Pathogens with Different Duty of Hospital Staff

目的了解医院各类人员咽部带菌及药敏状况,以加强医院感染的预防和控制。方法采用常规方法进行302份咽拭子标本培养和菌种鉴定,选择15种抗菌药物,用纸片扩散法对所分离的菌种进行药敏试验。结果医院人员咽部机会致病菌的分离率为30.13%,护理人员咽部带菌率为41.32%,明显高于医技(20%,P<0.05)和管理人员(9.52%,P<0.01),临床医师(29.29%)高于管理人员(9.52%,P<0.05);副流感嗜血菌占分离菌株的56.57%,金黄色葡萄球菌占20.2%,肺炎克雷伯菌占10.1%,表皮葡萄球菌占7.07%;金黄色葡萄球菌对青霉素和苯唑西林的耐药率分别为75%和60%,表皮葡萄球菌对青霉素和苯唑西林的耐药率分别为57.1%和85.7%;副流感嗜血菌对哌拉西林、头孢唑林、头孢哌酮和庆大霉素耐药率为100.0%,对阿米卡星耐药率达98.2%。结论医院各类人员咽部机会致病菌携带率存在差异;临床医护人员带菌率最高,管理人员最低;G+菌对青霉素和苯唑西林耐药率高,副流感嗜血菌对多种常用抗菌药物耐药;医院工作人员中临床医护人员是预防和控制医院感染的重点。

OBJECTIVE To investigate the pharyngeal opportunistic pathogens and their drug resistance related to different duty of the hospital staff, in order to improve the control and prevention of hospital infection. METHODS Totally 302 pharyngeal samples were cultured and isolated, and the tests of antibiotic susceptibility were performed for isolated strains to 15 kinds of antibiotics by using of the paper diffusion method. RESULTS The isolated rate of the opportunistic pathogens among hospital staff was 30.13% ,higher in nurses （41.32%） than in technicians （20%, P〈0.05） and administrators （9.52%, P〈0.01）, and higher in doctors （29.29%） than in administrators （P〈0.01） ; the strains of Haemophilus parainfluenzae , Staphylococcus aureus, Klebsiella pneumoniae, and S. epidermidis were 56. 57%, 20. 2%, 10. 1%, and 7. 07%, respectively; the rate of drug resistance of S. aureus and S. epidermidis to penicillin and meticillin were 75% and 60% and 57. 1% and 85.7%, respectively. The rate of drug resistance of H. parainfluenzae to piperacillin, cefazolin, cefoperazone, and gentamicin were all 100%, and to amikacin was 98.2%. CONCLUSIONS The isolated rate of opportunistic pathogens is different in different duty of the hospital staff, and it is the highest among clinical nurses and doctors, and the lowest in administrators; the ＂rate of drug resistance of G^＋ bacteria is high, and H. paralnfluenzae is multidrug resistant; clinical nurses and doctors are the important staff for preventing and controlling hospital infections.