外科患者医院感染病原菌及耐药性分析

Pathogens and Antibiotics Resistance of Nosocomial Infection in Surgical Patients

目的分析外科患者医院感染病原学分布及耐药性特点,为合理选择临床抗菌药物提供依据。方法将2010-2012年山东省济宁市第一人民医院外科送检的感染患者标本,按照《全国临床检验操作规程》标准分离、培养、鉴定细菌并判别药敏结果,对病原菌的分布及耐药情况进行回顾性分析。结果收集560份临床标本,共分离出细菌685株,其中革兰阴性杆菌(G-菌)452株,占65.99%(452/685),革兰阳性球菌(G+菌)185株,占27.01%(185/685);真菌48株,占7.01%(48/685)。在所有分离的病原体中,前6位分别为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、鲍曼不动杆菌、肺炎克雷伯菌和肠球菌。革兰阴性杆菌大多对亚胺培南敏感,革兰阳性球菌未发现耐万古霉素。结论山东省济宁市第一人民医院外科感染以革兰阴性菌为主,根据药敏试验结果正确选用有效抗菌药物进行治疗,对减少细菌耐药性的发生有重要意义。

Objective To analyze the etiology distribution and resistance characteristics of nosocomial infection in surgical patients,and to provide a basis for reasonable choosing antimicrobial drugs in clinical.Methods The specimens of patients from surgery department of The First People＇s Hospital of Jining in Jan.2010 to Dec.2012 were collected.According to National Clinical Laboratory Procedures,the bacteria were isolated,cultured and determined.The distribution of the etiology and drug resistance characteristics were both retrospectively analyzed.Results A total of 560 clinical samples were isolated from 685 bacterial strains,among which G-accounted for 65.99%（ 452 /685）,G＋bacteria accounted for 27.01%（ 185 /685） and fungi accounted for 7.01%（ 48 /685）.In all the isolated pathogens,the top 6 were Escherichia coli,Pseudomonas aeruginosa,Staphylococcus aureus,Acinetobacter baumannii,Klebsiella pneumoniae and Enterococci.Mostly G-were sensitive to imipenem,while G＋exhibited no resistance to vancomycin.Conclusion The surgical infections in this hospital are mainly caused by gram-negative bacterium.Correct drug choice for treatment according to the results of drug sensitive test is of great significance to reduce the occurrence of bacterial drug resistance.