神经内科住院患者合并下呼吸道感染的病原菌谱及耐药性分析

Spectrum and drug resistance of pathogens causing lower respiratory tract infections in hospitalized patients of neurology department

目的调查和分析神经内科患者合并下呼吸道感染的病原菌谱和耐药性,为预防医院感染和指导抗菌药物的合理使用提供依据。方法回顾性分析2013年-2015年并发下呼吸道感染的神经内科住院患者中分离的病原菌谱及其耐药性。结果共收集332份痰液,检出550株病原菌;革兰阴性菌364株(66.2%),以肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌为主;革兰阳性菌31株(5.6%),以金黄色葡萄球菌为主;真菌155株(28.2%),以白色念珠菌为主;肺炎克雷伯菌对除氨苄西林外的抗菌药物敏感性均较高;鲍曼不动杆菌和铜绿假单胞菌对大部分抗菌药物耐药性较高;大肠埃希菌对部分抗生素保持敏感;金黄色葡萄球菌对利奈唑胺、万古霉素敏感;未发现耐药真菌。结论神经内科住院患者下呼吸道感染病原菌以革兰阴性菌最常见,监测感染的病原菌谱及耐药性,对医院感染的防治非常重要。

Objective To investigate and analyze the spectrum and drug resistance of pathogens causing lower respiratory tract infections in hospitalized patients of the neurology department,so as to provide basis for the prevention of nosocomial infection and reasonable use of antibiotics. Methods Retrospective survey was taken to analyze the spectrum and drug resistance of pathogens causing lower respiratory tract infections in hospitalized patients of the neurology department from 2013 to 2015.Results 550 strains of pathogens were isolated from 332 sputum samples,of which there were 364（ 66. 2%） strains of Gram-negative bacteria,mainly including Klebsiella pneumonia,Acinetobacter baumannii,Pseudomonas aeruginosa and Escherichia coli; there were 31（ 5. 6%） strains of Gram-positive bacteria,among which Staphylococcus aureus was the dominant; there were155（ 28. 2%） strains of Fungi,among which Candida albicans was dominant. K. pneumonia strains were sensitive to most antimicrobial agents except ampicillin; A. baumannii strains and P. aeruginosa strains had high drug resistance to most antimicrobial agents,and Escherichia coli was sensitive to some antimicrobial agents; S. aureus was sensitive to linezolid and vancomycin; no drug resistant Fungi were detected. Conclusion The most frequent pathogen causing lower respiratory tract infections in hospitalized patients of neurology department is Gram-negative bacteria. It is of great importance for the prevention of nosocomial infections to monitor pathogen spectrum and its drug resistance.