乳腺外科院内感染病菌类型及耐药性变迁分析

Types of bacteria causing nosocomial infections and changes in drug resistance in patients undergoing breast surgery

目的了解乳腺外科手术患者的院内感染病原菌及其耐药性变迁情况,为临床抗感染治疗提供依据。方法院内感染患者送检标本分离病原菌,Vitek32全自动微生物分析仪鉴定菌种,K-B纸片法作药物敏感性实验。结果 2010年1月～2011年12月656例乳腺外科患者院内感染185例,院内感染发生率28.20%;分离病原菌163株,其中革兰阳性菌99株,占60.74%,革兰阴性菌56株,占34.36%,真菌8株,占4.91%。革兰阳性菌对头孢他啶、庆大霉素、红霉素、哌拉西林耐药率较高,对亚胺培南和加替沙星较敏感;革兰阴性菌对克林霉素、阿莫西林/克拉维酸、哌拉西林、头孢哌酮耐药,对亚胺培南、加替沙星和头孢他啶较敏感。2011年分离菌耐药率与2010年相比,差异无统计学意义(P<0.05)。结论乳腺外科院内感染病原菌耐药性较高,耐药性变迁不明显;根据药敏结果合理使用抗生素有利于院内感染的治疗。

Objectives To breast surgery. Methods ascertain changes in the bacterial resistance of nosocomial infections in patients undergoing Isolated pathogenic bacteria were identified with the Vitek32 automated microbe analyzer, and the K-B disc method was used to determine drug sensitivity. Results Of 656 patients undergoing breast surgery, 185 developed a nosocomial infection from January 2010 to December 2011, with an incidence rate of 28. 20%. One hundred and sixty-three strains of pathogenic bacteria were isolated; 99 were Gram-positive bacteria, 56 were Gram-negative bac teria, and 8 were fungi. Gram positive bacteria were resistant to eeftazidime, gentamycin, erythromycin, and piperacillin and sensitive to imipenem and gatifloxacin. Gram-negative bacteria were resistant to clindamycin, amoxicillin/clavulanic acid, piperacillin, and cefoperazone and sensitive to imipenem, gatifloxacin, and eeftazidime. There were no significant differences in rates of drug resistance in 2010 and 2011. Conclusion The pathogens responsible for nosocomial infec tions in patients undergoing breast surgery were highly drug resistant higher, though there were no obvious changes in resistance. Rational use of antibiotics in accordance with drug sensitivity results offers better treatment of nosocomial infections.