精神病患者医院感染的病原菌分析

Analysis of pathogenic bacteria of nosocomial infections in patients with mental disease

目的探讨精神病患者医院感染的病原菌分布和耐药性,为临床上有效防治提供参考。方法回顾性分析2011年10月-2012年10月收治的1 100例精神病患者临床资料,分析医院感染的发生情况、感染部位、病原菌分布以及耐药性,采用法国生物梅里埃公司VITEK-2Compact全自动细菌鉴定及药敏分析系统进行病原菌的鉴定及药敏试验。结果 1 100例精神病患者中发生医院感染623例,感染率为56.64%;感染部位以呼吸系统感染最常见占48.96%,其次为消化系统感染占29.05%;检出病原菌以革兰阴性菌为主338株占54.25%,其次真菌占29.05%和革兰阳性菌占16.69%;检出最多的3种病原菌分别为白色假丝酵母菌、肺炎克雷伯菌、大肠埃希菌,分别占18.78%、16.05%、15.25%;肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌及阴沟肠杆菌对氨苄西林表现出高度耐药,耐药率分别为100.00%、95.79%、100.00%及100.00%。结论精神病患者医院感染以呼吸、消化道感染为主,病原菌以革兰阴性菌最常见,临床上要注意日常的消毒、隔离,加强患者的护理工作,消除医院感染的易感因素,减少医院感染的发生;治疗上要重视根据药敏结果使用抗菌药物,以提高临床疗效,减少耐药菌的产生。

OBJECTIVE To investigate the pathogen drug resistance and clinical distribution of mental disease patients with nosocomial infections,and to provide the reference for clinical prevention.METHODS The clinical data of 1100patients with psychosis in our hospital from Oct.2011to Oct.2012was retrospectively analyzed,the incidence of nosocomial infections,infection sites,pathogen distribution and drug resistance situation of distribution were analyzed,and the pathogen distribution and drug resistance were tested by VITEK-2Compact full-automatic machine.RESULTS A total of 623cases with nosocomial infections in 1100patients with mental disease,accounting for 56.64%;the most common infection site was respiratory system,accounting for 48.96%,followed by gastrointestinal infections,accounting for 29.05%（181/623）;gram-negative bacterial infections were the most common,there were 338strains,accounting for 54.25%,and then was fungal infection（29.05%）and infection of gram-positive bacteria（16.69%）.Three kinds of the most common pathogens were Candida albicans（18.78%）,Klebsiella pneumoniae（16.05%）,Escherichia coli（15.25%）;K.pneumoniae,E.coli,Pseudomonas aeruginosa and Enterobacter cloacae to ampicillin showed highly resistant,resistant rate 100%,95.79%,100%and 100%.CONCLUSIONThe hospital infection of patients with mental disease mainly is respiratory and digestive tract infection.Gram negative bacteria are the most common bacteria.Clinical should pay attention to disinfection,isolation daily,strengthen nursing patients,eliminate the susceptible factors of nosocomial infections,reduce the incidence of nosocomial infections.The treatment should pay attention to the use of antibiotics based on susceptibility results to improve clinical treatment effect and reduce high drug resistant pathogens.