外科病房细菌感染耐药性分析

The Category and Antibiotics Resistance of Common Bacteria in Surgical Ward

目的研究外科感染的病原菌及其对常用抗生素的耐药性,以指导临床用药。方法采用Walkaway-40和Kirby-Bauer法对外科临床标本进行培养并检测其对多种抗生素的耐药性。结果外科病房2009年中送检标本共分离出780株致病菌,位列前6位的分别是鲍曼不动杆菌、金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、屎肠球菌。外科感染的标本来源以痰标本为最多,其次是脓/分泌物、血、尿、胆汁、引流液。万古霉素是革兰阳性球菌的有效药物,亚胺培南是革兰阴性球菌的有效药物。结论①外科感染细菌构成比主要与以革兰阴性菌为主,尤其鲍曼不动杆菌的上升趋势明显,而以金葡菌、肠球菌为代表的革兰阳性菌似有重新抬头趋势。②外科感染与外科本身疾病密切相关。③合理规范使用抗生素,根据药敏结果调整抗生素用药,对提高抗生素的疗效,降低细菌耐药的发展速度有重要意义。

Objective The phenomenon of antibiotics resistance of common bacteria in surgical system was studied to establish a principle of using antibiotics correctly.Methods Walkaway-40 and Kirby-Bauer method were used to examine the antibiotics resistance of isolated bacteria from surgical system.Results 780 strains were isolated in 2009, the first six common strains were Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas areuginosa, Escherichia coli, Klebsiella pneumoniae, Enterococcus Faecom.The sample collection comes from the sputum mostly and pus/secretion, bood, urine, bile, drainage successively.Vancomycin was effective to the Gram-positive bacteria coccus.Imipenem was effective to the Gram-negative bacteria.Conclusion ①The majority of constituent ratio of bacteria in surgical infection is Gram-negative bacteria, especially a arising proportion of Acinetobacter baumannii, and the Gram-positive bacteria coccus such as Staphylococcus aureus and enterococcus is bouncing as well.②The surgical infection is closely related to original disease.③Our results suggest that the surveillance of antibiotics resistance is improve the effect of antibiotics and to reduce the occurrence of antibiotics resistance of bacteria.