骨科病区医院感染的细菌谱及耐药分析

Clinical distribution of pathogens in cases of nosocomial infection and analysis of their drug resistance in a Department of Orthopedics

目的了解骨科病区医院感染病原菌分布及耐药情况,为临床合理选择抗菌药物提供依据。方法20042007年临床分离的病原菌用VITEK2系统和ID-GN卡鉴定,K-B法和VITEK2系统进行药敏试验,数据分析用WHO-NET5.1软件。结果415株分离病原菌中主要革兰阴性杆菌占59.52%,主要革兰阳性球菌占27.23%,真菌31株,占7.47%。革兰阴性菌中的大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌,革兰阳性菌中的金黄葡萄球菌、肠球菌等是感染菌谱的主要菌种。药敏显示大多数病原菌耐药性高,革兰阴性、阳性菌分别对亚胺培南、万古霉素敏感性最高,对其他常用抗菌素耐药率在30%70%之间。结论条件致病菌成为感染谱中的主要病原菌,其耐药率较高,应以药敏试验结果为依据合理选择抗菌药物。

Objective To investigate the clinical distribution of pathogens and their drug resistance in cases of nosocomial infection to promote rational use of antibiotics.Methods Clinical isolates from Jan 2004 to Dec 2007 in a Department of Orthopedics were identified by VITEK2 and ID-GN tested for drug resistance against antimicrobial agents by the K-B method and VITEK2 system.WHONET5.1 was used for analysis.Results Of 415 strains of pathogens,257 were G-bacilli（59.52%）,103 were G＋ bacteria（27.23%）,and 31 were fungi（7.47%）.Escherichia coli,Pseudomonas aeruginosa,and Klebsiella pneumoniae were the top three G-isolates,and Staphylococcus and Enterococcus were the most common G＋ isolates.The resistance rates of G-bacilli to imipenem and G＋ bacteria to vancomycin were low but resistance rates were 30%-70% for other commonly used antibiotics.Conclusion Conditioned pathogens are becoming the main pathogens of infectious diseases.These pathogens have higher drug resistance,so the selection and use of antibiotics should be based on the results of drug sensitivity tests.