摘要
目的通过对革兰阴性菌导致神经内科患者的感染部位与其在患者居住病房环境中的分布特征和对抗菌药物敏感性的分析,探讨革兰阴性菌对于神经内科患者的致病作用和传播途径,为革兰阴性菌感染的预防控制提供依据。方法选取2009年4-12月某神经内科住院患者为监测对象,对发生感染患者进行病原学检查和药敏试验,并对其所住病房的空气和床单位环境进行微生物学监测。结果医院感染部位依次为下呼吸道占91.30%、泌尿道占8.70%;41例感染患者发病24 h内的病原学检查中,革兰阴性菌(51.22%),均为革兰阴性杆菌;铜绿假单胞菌和肺炎克雷伯菌,均占34.77%,对环丙沙星和哌拉西林/他唑巴坦均较敏感;大肠埃希菌,占8.71%,对庆大霉素等药物敏感;在病房环境中检出大肠埃希菌和鲍氏不动杆菌等革兰阴性杆菌及少量革兰阴性球菌,且在病房空气、枕头和被子上数量差异无统计学意义。结论肺炎克雷伯菌和铜绿假单胞菌是引发神经内科患者感染常见病原菌,而大肠埃希菌、鲍氏不动杆菌等革兰阴性杆菌能够以病房环境为传播途径感染易感人群,在革兰阴性杆菌感染的早期,规范应用常规抗菌药物可获得较好治疗效果。
OBJECTIVE To analyze the nosocomial infection（NI） site,the distribution characteristics in the ward environment and drug sensitivity of Gram-negative which led to NI in the patient in neurological department,probe into pathogenic effect and transmission route of G-bacteria,provide theoretical basis for NI prevention induced by G-bacteria.METHODS All inpatients from Apr 2009 to Dec 2009 in a neurological department were collected as monitoring objectives.The pathogens and test its drug sensitivity were identified and under taken 41 cases NI patients.The microbiological character of indoor air of the room which NI patient lived and the bed units（pillow,quilt） of NI patient were monitored.RESULTS The frequent NI sites were as follows： lower respiratory tract（91.30%）,urinary tract（8.70%）;the pathogen identification for all 41 cases NI patients results within the first 24 hours showed that G-bacteria accounted for 51.22（all of them are G-baccis）.Pseudomonas aeruginosa and Klebsiella pneumoniae accounted for 34.77% separately which were sensitive to ciprofloxacin and Piperacillintazobactam.E.coli accounted for 8.71%,which was sensitive to gentamicin.E.coli,ABA and little G-cocci were detected in the ward environment.There were not differences among their distributions in indoor air,pillow and quilt（P0.05）.CONCLUSIONS P.aeruginosa and K.pneumoniae are frequent NI pathogens of the patients in neurological department.G-bacci E.coli,ABA,and so on can infect the susceptible patient through ward environment.Normative using antibiotics in early infection can obtain a good treatment effect.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第23期3790-3792,共3页
Chinese Journal of Nosocomiology
基金
唐山市临床医学研究计划基金项目(08130214C)
关键词
神经内科
革兰阴性菌
医院感染
预防
控制
Neurological department
Gram-negative bacteria
Nosocomial infection
Prevention
Control
