摘要
目的调查肝胆外科医院近2年病原菌分布及耐药情况,为临床合理选择抗菌药物提供依据。方法对2008年1月-2009年12月医院肝胆外科患者各类送检标本的病原菌种类、分布和对25种抗菌药物的耐药性进行回顾性分析。结果共分离出病原菌594株,其中革兰阴性菌418株(70.4%),革兰阳性菌142株(23.9%),真菌34株(5.7%);革兰阴性菌以大肠埃希菌(19.9%)居多、革兰阳性菌以屎肠球菌(10.1%)居多,真菌主要为热带假丝酵母菌和白色假丝酵母菌;主要分离部位为腹腔引流液、痰液和胆汁;革兰阴性杆菌对碳青酶烯类以及含有酶抑制剂的药物耐药率较低,鲍氏不动杆菌对目前的抗菌药物耐药率高达81.7%～99.7%;耐甲氧西林金黄色葡萄球菌(MRSA)对常用抗菌药物耐药性高于甲氧西林敏感金黄色葡萄球菌(MSSA);没有检测到对万古霉素耐药的葡萄球菌属;肠球菌属对利奈唑胺和万古霉素的耐药率较低。结论肝胆外科患者医院感染主要病原菌以革兰阴性菌为主,定期监测病原菌并按照药敏结果选择药物治疗很有必要。
OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria isolated from hepatobiliary surgery wards in the past two years.METHODS The distribution,category and drug resistance of pathogenic bacteria isolated from patients in hepatobiliary surgery department from 2008 to 2009 were retrospectively analyzed.RESULTS A total of 594 pathogenic bacteria were isolated.Among them,418 isolates（70.4%）were Gram-negative bacteria,142 isolates（23.9%）were Gram-positive bacteria,and 34 isolates（5.7%）were fungi.The most common Gram-negative bacteria were Escherichia coli（19.9%of the isolates） and the dominant Gram-positive pathogenic bacteria were Enterococcus faecium（10.1%）.Candida tropicalis and C.albicans were the major fungi,most of which isolated from sputum and bile.The drug resistant rates of the Gram-negative pathogenic bacteria to carbapenem and containing enzyme inhibitor were low,and the drug resistant rates of Acinetobacter baumanii to current antibiotics highly reached 81.7-99.7%.No Staphylococcus strain resistant to vancomycin was detected.The drug resistance of meticillin-resistant Staphylococcus aureuse（MRSA） to commonly used antibiotics were higher than that of meticillin-sensitive S.aureus（MSSA）.The drug resistant rates of Enterococcus to vancomycin and linezolid remained lower.CONCLUSION The predominant pathogenic bacteria isolated from hepatobiliary surgery are Gram-negative bacteria.It is necessary to periodically monitor the pathogens and choose antibiotics in accordance with drug sensitive tests.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第18期2853-2855,共3页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(30972523)
关键词
病原菌分布
耐药性
医院感染
Pathogenic bacteria distribution
Drug resistance
Nosocomial infection
