外科重症患者术后感染病原菌种类及药物敏感性分析

Analysis of distribution and sensitivity of pathogens in patients with postoperative infection in surgical department

目的：探讨外科重症患者术后感染菌群分布和药物敏感性情况，为临床重症患者合理用药提供实验室依据。方法：采用回顾性研究方法，分析2004～2006年我院外科重症患者术后感染及药物敏感性情况。结果：外科重症术后以呼吸道感染最常见，送检标本以下呼吸道标本为主。排在前3位的科室分别为肝胆外科、神经外科和泌尿外科。前3位感染菌分别为大肠埃希菌、金黄色葡萄球菌和铜绿假单胞菌。大肠埃希菌产超广谱β-内酰胺酶菌株逐年增多，以亚胺培南最敏感（95．34％）；金黄色葡萄球菌以万古霉素最敏感（100％），未发现耐万古霉素菌株，耐苯唑西林菌株占54，62％，产β-内酰胺酶菌株约95％；铜绿假单胞菌以丁胺卡那霉素（78.61％）和亚胺培南（67．30％）最敏感，多重耐药性显著。结论：外科重症术后患者感染易出现，感染菌株耐药性高，不易控制，应定期、及时的按照细菌培养和药物敏感性检测结果慎重选用抗生素，防止多重耐药菌株的出现和爆发流行。

Objective： To explore the distribution and sensitivity of pathogens in patients with postoperative infection in surgical department and give the laboratory suggestions of clinical rational use of antibiotics. Methods：Retrospective method was used to analyze the distribution and sensitivity of pathogens in patients with postoperative infection in surgical department of our hospital from 2003 to 2006. Results：The most common infected location was respiratory tract and the postoperative infection occurred most in Neurosurgery, Urinary Surgery and Hepatobiliary Surgery Department. The first 3 infection bacteria were Escherichia coll. , Staphylococus aureus and Pseudomonas aeruginosa. The infection rate of Escherichia coll. producing ESBL increased year by year and Escherichia coli. was most sensitive to imipenem（95.35%）. The most sensitive antibiotic to Staphylococus aureus was vancomycin （100%）. The proportion of methicillin resistant staphylococcus aureus was 54. 62% and β- lactamase - producing Staphylococus aureus was about 95% in three years. Pseudomonas aeruginosa was most sensitive to amikacin（78. 61% ） and imipenm（67.30% ）. Conclusion： Postoperative infection in surgical department was common and drug - resistance was also common. Clinical doctors should use antibiotics carefully according to the results of bacterial culture and drug - sensitive examination in order to prevent multiple drug - resistance bacteria.