神经内外科重症患者多药耐药菌感染分析

Multidrug-resistant bacteria causing infections in critically ill patients of neurosurgery and neurology department

目的研究神经内外科重症患者医院感染的多药耐药菌的分布,指导临床合理应用抗菌药物。方法选取医院2011年6月-2012年12月神经内科和神经外科危重病患者共计1290例,利用BACTECTM9000培养系统分离培养病原菌,并对分离出的病原菌按K-B琼脂法进行药敏试验,结果判定严格按照美国临床实验室标准化委员会2005年版。结果神经内科重症患者分离培养出病原菌885株,神经外科重症患者分离培养出病原菌486株,神经内科和神经外科重症患者的主要病原菌以鲍氏不动杆菌、肺炎克雷伯菌和铜绿假单胞菌为主,分别占31.98%、30.28%和14.92%;神经内科和神经外科感染患者检出多药耐药菌分别占82.15%、80.25%,主要多药耐药菌为鲍氏不动杆菌、肺炎克雷伯菌和铜绿假单胞菌,分别占35.38%、1 32.31%和12.56%。结论应做好神经内外科重症患者的护理工作,预防感染的发生,当感染发生时立即确定病原菌的类型,合理选择抗菌药物进行及时有效的治疗。

OBJECTIVE To analyze the distribution of muhidrug-resistant bacteria infections in neurology and neurosurgery severe patients so as to provide reasonable way to use antibacterial drugs. METHODS A total of 1290 severe patients in neurology and neurosurgery from Jun. 2011 to Dec. 2012 were selected. The pathogenic bacteria were isolated and cultured in BACTECTM9000 system, and K-B agar method was used for drug sensitive test to isolated bacteria. The result was strictly judged by NCCLS 2005. RESULTS A total of 885 strains of pathogenic bacteria were isolated from neurology severe patients, and 486 strains of pathogenic bacteria were isolated from neurosurgery severe patients. Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the main pathogenic bacteria in neurology and neurosurgery, accounting for 1.98%, 30.28%, and 14.92%; muhidrug-resistant bacteria accounted for 82. 15% in the neurology department, 80. 25% in the neurosurgery department; the muhidrug-resistant A. baumannii, K. pneumoniae, or P. aeruginosa strains were the predominant muhidrug-resistant bacteria, accounting for 35. 38%, 1 32. 31%, and 12. 56%, respectively. CONCLUSION Great importance should be attached to the nursing for the critically ill patients in the neurosurgery and neurology department so as to prevent the infections; the species of pathogens should be determined once the infections occurs, and antibiotics should be reasonably selected for the timely treatment.