神经外科住院患者感染的病原菌分布与耐药性分析

Distribution of pathogenic bacteria and analysis of drug resistance in infections in patients hospitalized in the department of neurosurgery

目的分析我院神经外科住院患者感染的病原菌分布及其耐药情况,为临床合理应用抗菌药物提供依据。方法回顾性收集我院2013年1月至2015年12月神经外科住院患者感染的病原菌资料,并对其药敏数据进行统计分析。结果共分离出病原菌450例。其中革兰阴性杆菌最多,为331例,占73.56%,占前3位的分别是肺炎克雷伯杆菌79例,占17.56%;鲍曼不动杆菌75例,占16.67%;大肠埃希菌71例,占15.78%;其次为革兰阳性球菌共108例,占24.00%,其中金黄色葡萄球菌最多为46例,占10.22%;共分离出真菌11例,占2.44%。病原菌阳性标本中痰液最多271例,占60.22%,其次是尿液87例,占19.33%;不同病原菌对临床常用抗菌药物的耐药率及敏感率不同。结论神经外科住院患者的感染以革兰阴性杆菌为主,其中居前3位的分别是肺炎克雷伯杆菌、鲍曼不动杆菌及大肠埃希菌。革兰阳性球菌中以金黄色葡萄球菌为主。临床上应根据药敏实验结果合理使用抗菌药物,以达到良好的治疗及预防术后感染的目的。

Objective To investigate the distribution of pathogenic bacteria and drug resistance status causing infections in patients hospitalized in the department of Neurosurgery in our hospital so as to provide some references for the rational use of antibiotics. Methods A retrospective analysis was carried out to collect the data of the distribution of pathogenic bacteria of infections in the department of neurosurgery from January 2013 to December 2015 and to ana- lyze the results of its drug sensitive test. Results Totally 450 strains of pathogens have been isolated, among which the Gram-negative bacilli was dominant, accounting for 73.56% （331 strains ）. Klebsiella pneumoniae （79 strains） ,Acine- tobacter baumannii （ 75 strains ） and Escherichia coli （ 71 strains） were the top three species of the isolated pathogens. The constituent ratio was 17. 56% , 16. 67% and 15.78%, respectively. The Staphylococcus aureus （ 46 strains ） in Gram-positive bacilli accounted for 10. 22%. The Fungus accounted for 2. 44%. The pathogens were mostly from speci- men with sputum,accounting for 60. 22% ,and secondly from urine,accounting for 19. 33%. The drug resistance rates of different pathogens were different. Conclusion Gram-negative bacilli are the major germ causing infections in the department of neurosurgery. Among them, Klebsiella pneumoniae,Acinetobacter baumannii and Escherichia coli were the top three species of bacteria. Clinicians should pay attention to the rational use of antibiotics according to the result of drug-sensitive test in order to treat and prevent the postoperative infections.