失血性休克患者锁骨下静脉置管感染的病原学分析

Etiological analysis of clavicle related infections after venous catheterization in patients with hemorrhagic shock

目的调查分析失血性休克患者锁骨下静脉置管感染的病原学及其耐药性,为临床治疗提供参考依据。方法选取2011年3月-2012年3月失血性休克发生锁骨下静脉置管相关性感染患者共87例,采集感染患者的穿刺部位样本进行病原学检测和药敏试验,采用SPSS17.0软件进行统计分析。结果 87例感染患者送检标本检出病原菌中以表皮葡萄球菌最多占46.0%,其次为大肠埃希菌占24.1%以及真菌占13.8%;革兰阳性球菌对万古霉素的耐药率最低为4.2%,其次是四环素为35.4%,对阿莫西林的耐药率最高为100.0%;革兰阴性杆菌对阿米卡星以及头孢曲松的耐药率相对较高,分别为96.3%和92.6%。结论失血性休克锁骨下静脉置管相关性感染常见的病原菌为表皮葡萄球菌,为了提高治疗效果,要根据病原菌检查以及药敏结果选择抗菌药物的治疗。

OBJECTIVE To observe and analyze the etiology and drug resistance of vein‐related infections in pa‐tients with hemorrhagic shock so as to provide clinical references for treatments .METHODS From Mar .2011 to Mar .2012 ,a total of 87 cases occurred hemorrhagic shock and got infected during subclavian vein cathetering were selected .The samples of the puncture sites were detected by both etiological test and drug sensitivity test . All data were analyzed by SPSS 17 .0 software .RESULTS Staphylococcus epidermidis （46 .0% ） dominated the most in all pathogens found in those samples ,followed by Escherichia coli （24 .1% ） and fungi （13 .8% ） .Gram‐positive cocci were sensitive to vancomycin with the drug resistance rate of 4 .2% ,followed by tetracycline with the rate of 35 .4 % .They were highly resistant to amoxicillin with drug resistance rate of up to 100 percent .Gram‐negative bacilli were highly resistant to Amikacin and Ceftriaxone with the rate of 96 .3% and 92 .6% . CONCLUSION S .epidermidis is the most common pathogen infected by patients with hemorrhagic shock after subclavian vein cathetering .Pathogenic examination and drug sensitivity results can be referred w hen choosing an‐tibiotics so as to improve curative effect .