住院精神病患者细菌分布及耐药分析

Analysis of pathogenic bacteria distribution and drug resistance in psychopathic inpatients

目的分析上海市精神卫生中心住院患者细菌种类、分布及耐药性,为临床医师合理选用抗菌药物提供参考。方法对2014年12月至2016年8月该院住院患者的细菌培养及耐药性进行分析。结果从符合条件的8 382例培养标本中共分离510株阳性菌株,阳性检出率为5.89%。其中,检出率排前5位分别为大肠埃希菌(占23.92%)、凝固酶阴性葡萄球菌(占13.92%)、金黄色葡萄球菌(占11.57%)、其他革兰阴性菌(占11.18%)和肺炎克雷伯菌(占10.78%)。耐药性分析显示,革兰阴性菌对临床常用抗菌药物耐药率较高的有氨苄西林、头孢噻肟等,革兰阳性菌对青霉素、红霉素、苯唑西林耐药率较高。结论该院分离标本均来自精神病患者,精神病患者自主卫生意识差,容易罹患各种感染性疾病。医院应及时监测细菌耐药性情况,临床应重视病原菌检查,根据药敏合理采用抗菌药物,减少病原菌耐药的发生。

Objective To analyze the species,distribution and drug resistance of bacteria among inpatients in our hospital to provide a reference for clinical doctors rationally selecting antibacterial drugs.Methods The bacterial culture results and their drug resistance in the inpatients from December 2014 to August 2016 were retrospectively analyzed.Results Totally 510 strains of positive bacteria were isolated from 8 382 cultured samples and the positive detection rate was 5.89%.Among them,the top five of detection rates were Escherichia coli（23.92%）,Coagulase negative Staphylococcus（13.92%）,Staphylococcus aureus（11.57%）,other Gramnegative bacteria（11.18%）and Klebsiella penumoniae（10.78%）.The drug resistance analysis showed that Gram negative bacteria had higher resistance to commonly used antibacterial drugs in clinic such as ampicillin,cefotaxime,etc.,and Gram positive bacteria had higher resistance to penicillin,erythromycin and oxacillin.Conclusion The isolated specimens in this hospital were come from the psychiatric patients.The psychiatric patients have poor health awareness and are more likely to suffer from various infectious diseases.Hospital should timely monitor the bacterial drug resistance situation,and clinic should pay attention to pathogenic bacterial detection and rationally select the bacterial drugs for conducting antibacterial therapy and reducing the occurrence of pathogenic bacterial drug resistance.