神经内科下呼吸道感染患者病原菌分布特征

Distribution of pathogenic bacteria causing lower respiratory tract infections among neurology inpatients

目的神经内科下呼吸道感染住院患者的病原菌分布特征,为促进患者的合理用药提供参考依据。方法采用方便抽样自大连市选取2家三级甲等医院,随机选取2014年1月1日—2015年12月31日神经内科住院患者合并下呼吸道感染的病历1 600份,提取病原菌分布相关信息。结果共分离出病原菌2 109株,其中革兰阴性菌1 372株,以肺炎克雷伯菌(17.16%,362/2 109)居多;革兰阳性菌624株,以金黄色葡萄球菌(14.32%,302/2 109)居多;真菌113株,以白色假丝酵母菌(2.66%,56/2 109)居多。71.85%(217/302)的金黄色葡萄球菌感染患者进行了耐药性分析,耐药率最低的为万古霉素(0.00%,0/217);78.73%(285/362)的肺炎克雷伯菌感染患者进行了耐药性分析,耐药率最低的为美罗培南(3.16%,9/285)。结论加强住院患者病原菌的监测和耐药性分析,将有助于促进合理用药、预防医院感染,提高治疗的安全性和有效性。

Objective To study distributive characteristics of pathogenic bacteria causing lower respiratory tract infection in neurology inpatients and to provide evidences for promoting rational drug use. Methods Two third-grade class-A hospitals were selected with convenience sampling in Dalian city of Liaoning province; then 1 600 neurology in- patients with lower respiratory tract infections during hospitalization between January 1 st,2014 through December 31 st, 2015 were selected randomly and their medical records were extracted and analyzed. Results Of the 2 109 strains of pathogenic bacteria totally isolated from the inpatients, 1 372 and 624 were gram-negative and gram-positive bacteria and 113 were fungi, with 362 （17.16% of all the isolates） Klebsiella pneumoniae strains, 302 Staphylococcus aureus （ 14. 32% ） ,and 113 Candida albicans （2. 66% ） ,respectively. Drug resistance was performed for 71.85%0 （217/302） and 78.73 % （ 285/362 ） of the isolated Staphylococcus aureus and Klebsiella pneumoniae strains ; no Staphylococcus au- reus strains resistant to vancomycin were detected and only 3.16% of Klebsiella pneumoniae strains were resistant to meropenem. Conclusion Pathogen surveillance and drug resistance test for isolated pathogens among inpatients may promote rational drug use and nosocomial infection prevention.