某院外科感染常见病原菌分布及耐药性分析

Distribution and Drug Resistance of Common Pathogenic Bacteria in Surgical Infection

目的了解医院外科感染常见病原菌的分布及其耐药性,为外科院内感染合理选用抗生素提供参考。方法收集山东省医学科学院第三附属医院外科2013-08/2015-08住院且发生感染的患者210例,分离培养并鉴定细菌,采用K-B纸片法进行药敏试验,对病原菌的来源、分布及耐药情况进行进行统计分析。结果在210例患者中发生医院感染32例,感染率为15.23%;共检测出病原菌65株,以革兰阴性菌为主,占58.46%(38/65),其中大肠埃希菌(占27.69%)居多,其次为铜绿假单胞菌(占9.23%),肺炎克雷伯菌(占6.15%);检测出革兰阳性菌23株(占35.38%),其中以金黄色葡萄球菌为多(占16.92%),其余依次为表皮葡萄球菌、肠球菌及溶血性链球菌;产ESBLs酶大肠埃希菌、铜绿假单胞菌和检出率肺炎克雷伯菌分别为55.56%、50.00%和40.00%,未发现产ESBLs株对亚胺培南的耐药株;耐甲氧西林金黄色葡萄球菌检出率为45.45%,但对万古霉素和呋喃妥因的敏感率为100.00%。真菌4例,占6.15%,以白色念珠菌为主。结论山东医科院第三附院外科感染及多重耐药情况较严重,以革兰阴性菌为主,对亚胺培南敏感。

Objective To investigate the distribution and drug resistance of common pathogenic bacteria for in- fection in the surgical department of the hospital and provide reference for rational use of antibiotics against nosocornial infection. Methods Included into the study were 210 patients who were hospitalized in the Department of Surgery of the Third Affiliated Hospital of Shandong Academy of Medical Sciences and experienced in- fection during the period from August 2013 to August 2015. Bacteria were isolated and identified, and drug sensitivity test was performed by K - B disc method. Sources, distribution and drug resistance of pathogenic bacteria were statistically analyzed. Results Among the 210 patients, nosocomial infection occurred in 32 （15.23%） ; 65 isolates were obtained, and gram -negative bacteria accounted for 58.46% （38/65）, among which E. coli accounted for the most （27. 69% ）, followed by Pseudomonas aeruginosa （9. 23% ） and Kleb- siella pneumoniae （35.38%）. Twenty three （35.38%） gram -positive isolates were obtained, among which Staphylococcus aureus accounted for the most （16.92%）, followed by Staphylococcus epiderrnidis, entero- cocci and Streptococcus hemolytieus. The detection rates of ESBLs - producing E. coli, Pseudomonas aerugi- nosa and Klebsiella pneumoniae were55.56% , 50% and 40% , respectively. No imipenem - resistant ESBLs - producing strain was found. The detection rate of methicillin resistant Staphylococcus aureus was 45.45 % , while 100. 00% were sensitive to vancomycin and nitrofurantoin. Fungi were found in 4 （6. 15% ） patients, with Canidida albicans accounting for the majority. Conclusion Infection and multidrug resistance are serious in the surgical department of the hospital. Gram - negative bacteria account for the majority and are sensitive to imipenem.