摘要
目的调查郑州大学第一附属医院2014年院内感染常见病原菌分布及耐药现况,为院内感染的防治提供依据。方法回顾性调查分析郑州大学第一附属医院2014年1月至2015年1月所分离的病原菌,并对其进行耐药性分析。结果检出院内感染病原菌1 246株,其中革兰阴性菌878株(70.47%),主要包括鲍曼不动杆菌(236株,26.88%),大肠埃希菌(227株,18.22%),肺炎克雷伯杆菌(159株,18.11%),铜绿假单胞菌(119株,13.55%);革兰阳性菌251株(20.14%),主要包括金黄色葡萄球菌(135株,53.78%),屎肠球菌(50株,19.92%)及粪肠球菌(17株,6.77%);真菌117株(9.39%),主要包括白色念珠菌(55株,47.01%),热带念珠菌(24株,20.51%),光滑念珠菌(11株,9.40%),克柔念珠菌(7株,5.98%)。感染主要分布在下呼吸道,共计641例,占51.44%,其次为血流感染(199例,15.97%),手术切口感染(121例,9.71%),泌尿系感染(113例,9.07%),腹腔感染(99例,7.95%)。下呼吸道感染以鲍曼不动杆菌为主,占31.36%,其次为肺炎克雷伯杆菌、铜绿假单胞菌、金黄色葡萄球菌、白色念珠菌。院内感染病原菌对常用抗生素严重耐药,真菌亦出现耐药现象。结论院内感染以下呼吸道、革兰阴性菌感染为主,对常用抗生素严重耐药,临床上需严格掌握抗生素的使用指征,结合药敏试验合理应用抗菌药物,应警惕真菌耐药性。
Objective To Investigate the distribution of pathogenic bacteria of nosocomial infection and its drug -resistances in 2014 in the First Affiliated Hospital of Zhengzhou University,providing evidences for the prophylaxis and treatment. Methods A retrospective analysis was made for all the isolated bacteria from January of 2014 to January of 2015,and its drug -resistance was analyzed.Results A total of 1 246 bacterial strains were isolated,including 878 strains of Gram -negative bac-teria （70.47%）,251 strains of Gram -positive bacteria（20.14%）and 117 strains of fungi（9.39%）.In Gram -negative bac-terias,there were 236 （26.88%）cases of Acinetobacter baumannii,227 （18.22%）cases of Escherichia coli,159 （18.11%） cases of Klebsiella pneumoniae ,119 （13.55%）cases of Pseudomonas aeruginosa.The main pathogens of the Gram -positive bacterias were Staphyloccocus aureus Rosenbach （135 cases,53.78%）,Enterococcus Faecom （50 cases,19.92%）and En-terococcus faecalis （17 cases,6.77%）.The fungi mainly consisted of Candida albicans （55 cases,47.01%）,Candida tropi-calis（24 cases,20.51%）,Candida glabrata（11 cases,9.40%）and Candida krusei （7 cases,5.98%）.Lower respiratory tract （641 cases,51.44%）was the most susceptible to infection,blood infection （199 cases,15.97%）,followed by surgical sites infection （121 cases,9.71%）,urinary system （113 cases,9.07%）and abdominal infection （99 cases,7.95%）.The main pathogen of the lower respiratory was Acinetobacter baumannii,occupied 31.36%,followed by Klebsiella pneumonia, Pseudomonas aeruginosa,Staphyloccocus aureus Rosenbach,Candida albicans.The bacteria were highly resistant to commonly used antimicrobials.Conclusion The lower respiratory tract was the most susceptible to infection in nosocomial infection,and the Gram -negative bacteria was the most common pathogenic bacteria.They were highly resistant to commonly used antimicrobi-als.The rational selection and use of antibiotics should base on the results of monitoring of bacterial resistance and drug -sensi-tivity tests.The drug -resistance of fungi should be vigilant.
出处
《河南医学研究》
CAS
2016年第6期961-965,共5页
Henan Medical Research
基金
河南省卫生科技攻关项目(201102002)
关键词
内感染
病原菌
耐药性
nosocomial infection
pathogenic bacteria
drug -resistances
