康复期脊髓损伤患者医院感染的致病菌及其耐药性

Pathogenic bacteria and drug resistance of nosocomial infection in patients with spinal cord injury in rehabilitation stage

目的研究康复期脊髓损伤患者医院感染的致病菌与耐药性。方法选择2013年6月至2015年6月于本院接受康复治疗的脊髓损伤患者400例,其中136例患者发生医院感染。采用Micro Scan Walk Away微生物鉴定药敏测试系统对分离出的感染样本进行细菌鉴定和药敏试验,探究康复期脊髓损伤患者医院感染的致病菌及耐药性。结果 400例脊髓损伤患者中136例发生医院感染,感染率为34.00%。脊髓损伤患者医院感染部位的分布较广,主要分布在泌尿道(68.42%)和下呼吸道(23.03%)。脊髓损伤患者医院感染的病原菌主要为大肠埃希菌(44.74%)和铜绿假单胞菌(18.42%)。脊髓损伤患者医院感染病原菌的耐药性整体较强,其中大肠埃希菌对哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的耐药性较弱,分别为4.41%和8.82%,铜绿假单胞菌对哌拉西林/他唑巴坦、头孢哌酮舒巴坦、异帕米星和阿米卡星的耐药率为0.00%,肺炎克雷伯菌对哌拉西林他唑巴坦和头孢哌酮舒巴坦的耐药性较弱,分别为17.65%和0.00%。结论脊髓损伤患者医院感染的部位主要为泌尿道和呼吸道,以大肠埃希菌和铜绿假单胞菌为主,耐药性较强。

Objective To investigate the pathogenic bacteria and drug resistance of nosocomial infection in patients with spinal cord injury.Methods Total of 400 hospitalized cases with spinal cord injury were selected in our hospital from June 2013 to June 2015, including 136 cases with hospital infection. MicroScan WalkAway microbe drug susceptibility test system was applied to isolate infected bacteria identification and drug sensitive test samples, and the pathogenic bacteria and drug resistance of spinal cord injury patients with hospital infection during rehabilitation phase were analyzed.Results There were 136 cases with hospital infection among 400 cases with spinal cord injury, the infection rate was 34%. The distribution of nosocomial infection in patients with spinal cord injury was relatively wide, mainly distributed in the urinary tract (68.42%) and lower respiratory tract (23.03%). The main pathogenic bacteria of nosocomial infection in patients with spinal cord injury wereEscherichia coli (44.74%) andPseudomonas aeruginosa (18.42%). Drug resistance of patients with spinal cord injury and nosocomial infection were high, which were 4.41% and 8.82% ofEscherichia coli to piperacillin tazobactam and cefoperazone sulbactam. While the resistance rates ofPseudomonas aeruginosa to piperacillin tazobactam, cefoperazone sulbactam, ISO pamidronate star and amikacin were all 0.00%, andKlebsiella pneumoniae to piperacillin sodium and cefoperazone sulbactam were 17.65% and 0.00%.Conclusions The sites of nosocomial infection for patients with spinal cord injury were mainly urinary tract and respiratory tract, mainlyEscherichia coli and Pseudomonas aeruginosa, with high drug resistance.