呼吸系统疾病住院患者医院感染常见病原菌分布及耐药性分析

Analysis on distribution and drug resistance of common pathogens of nosocomial infections in hospitalized patients with respiratory diseases

目的探讨呼吸系统疾病的住院患者发生医院感染病原菌分布及其对抗菌药物的耐药性,为降低患者感染发生率提供依据。方法随机选取2011年6月-2013年6月收治的260例发生呼吸系统疾病感染患者进行研究,对感染患者的痰液进行病原菌分离,并采用纸片扩散法进行药敏试验,研究资料均采用计数方法,利用Excel软件进行分析。结果 260例感染患者以肺部感染最多130例,占47.10%,其次为消化系统、泌尿系统,分别占29.23%、15.39%;痰标本中共分离出病原菌276株,其中革兰阴性菌195株占70.65%、革兰阳性球菌64株占23.19%、真菌17株占6.16%;革兰阴性菌对头孢曲松耐药率最高,鲍氏不动杆菌耐药率达100.00%,而对阿米卡星、亚胺培南、头孢哌酮/舒巴坦耐药率最低,均<10.00%;革兰阳性菌对青霉素G、克林霉素和甲氧苄啶的耐药率较高,约80.00%。结论革兰阴性菌是呼吸系统疾病住院患者发生医院感染的常见病原菌,且变异性大、耐药性较强,临床医师应加强病原菌检测及耐药性监测,合理使用抗菌药物。

OBJECTIVE To analyze distribution and drug resistance of common pathogens of nosocomial infections in hospitalized patients with respiratory diseases and provide basis for reducing the infection rate. METHODS Totally 260 patients with respiratory diseases accompanied by nosocomial infections from Jun. 2011 to Jun. 2013 in our hospital were randomly selected and studied. The pathogens were isolated from patientsp sputum, and the susceptibility testing was conducted by disk diffusion method. Enumeration data were analyzed with the Excel software. RESULTS The most infections were pulmonary infections in the 260 patients （130 eases~ 47. 10%）, followed by digestive system infections （29. Z3%） and urinary tract infections （15.39%）. Totally 276 strains of pathogens were isolated from the sputum specimens, including 195 gram-negative bacteria accounting for 70.65 %, 64 gram-positive cocci accounting for 23.19%, 17 fungi accounting for 6.16%. The resistance analysis found that gram-negative bacteria had the highest resistance to ceftriaxone, Acinetobacter baumannii reached a resistance up to 100. 00%. A. baumannii had the lowest resistance to amikaein, imipenem, cefoperazone/sulbaetam, all ~10.00%. Gram-positive bacteria had high resistance to penicillin G, clindamycin and trimethoprim, all up to 80.00%. CONCLUSION Gram-negative bacteria were common pathogens of nosocomial infections in hospitalized patients with respiratory diseases and its variability and drug resistance is high. Clinicians should enhance pathogen detection and monitoring of drug resistance, and rationally use antimicrobial drugs.