摘要
目的分析神经外科气管切开患者医院获得性肺炎多重耐药菌分布及耐药性的特征。方法应用细菌学方法对2014年1月-2016年12月神经外科305例气管切开患者医院获得性肺炎的痰液标本进行检测及其药敏试验并分析感染的相关因素。结果 305份痰标本共检出多重耐药菌184株,检出率为60.3%。其中革兰阴性杆菌111株,占60.3%,以铜绿假单胞菌(17.39%)为主,其次为鲍曼不动杆菌(16.30%)、嗜麦芽窄食单胞菌(13.04%)。革兰阴性杆菌除了对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦有较好的敏感性外,对其他抗菌药有很强的耐药性。多重耐药菌感染与患者的GCS评分、使用呼吸机、肺部基础疾病、使用碳青霉烯类抗生素有关。结论神经外科气管切开患者多重耐药菌耐药性严重,应从阻遏耐药菌传播和产生着手,合理使用抗菌药物,加强手卫生,采取综合的防治措施和多环节监控。
Objective To investigate the distribution and drug resistance of multi-resistant bacteria in patients with hospital-acquired pneumonia（ HAP） infection after tracheotomy in neurosurgery department. Methods The multi-resistant bacteria,which were isolated from the sputum specimens obtained from the HAP patients after tracheotomy from Jan 2011 to Dec 2013,were conducted for detection and drug resistance test,and the factors causing infections were analyzed. Results 184 strains of multi-resistant bacteria were isolated from 305 cases of HAP patients after tracheotomy,with the detection rate of 60. 3%,among which Gram-negative bacteria was the dominant（ n = 111,60. 3%）,followed by Pseudomonas aeruginosa（ 17. 39%）,Acinetobacter baumannii（ 16. 30%）,Stenotrophomonsas maltophilia（ 13. 04%）. Gram-negative bacilli was sensitive to cefoperazone/sulbactam,piperacillin/tazobactam,but strong resistant to other antimicrobial drugs. Multidrug-resistant infections are associated with GCS scores of patients,ventilator,underlying lung disease,and carbapenem-based antibiotics. Conclusion Drug resistance of multi-resistant bacteria in patients with HAP infection after tracheotomy in neurosurgery department is sever,so it is necessary to start from stopping the spread of drug-resistant bacteria and production,the rational use of anti-bacterial drugs,strengthening hand hygiene,and taking comprehensive prevention and control measures as well as multi-link monitoring.
作者
木冬妹
张巧萍
陶浙燕
尹波
MU Dong - mei, ZHANG Qiao - ping, TAO Zhe - yan, YIN Bo(Department of Neurosurgery, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, Chin)
出处
《中国卫生检验杂志》
CAS
2018年第4期444-446,455,共4页
Chinese Journal of Health Laboratory Technology
基金
浙江省自然科学基金项目(Y15H090056)
关键词
神经外科
气管切开
获得性肺炎
多重耐药菌
Neurosurgery department
Tracheotomy
Hospital - acquired pneumonia
Muhi - resistant bacteria
