摘要
目的分析四川大学华西医院神经外科术后感染患者分离病原菌分布及耐药情况,为临床预防与治疗提供依据。方法回顾临床病历纳入分析数据,采用WHONET 2018软件分析2014~2018年神经外科送检微生物标本分离菌株的分布情况和药敏结果。结果 4 209株临床病原菌以革兰阴性菌为主,占77.6%(3 266/4 209),革兰阳性菌占19.9%(837/4 209),真菌占2.5%(106/4 209)。分离量最多的病原菌前五位分别是肺炎克雷伯菌21.4%(899/4 209)、鲍曼不动杆菌15.5%(651/4 209)、铜绿假单胞菌12.2%(515/4 209)、大肠埃希菌8.6%(361/4 209)和金黄色葡萄球菌6.7%(281/4 209);按标本类型分,痰液60.6%(2 551/4 209)、血液12.0%(505/4 209)、尿液10.6%(446/4 209)、脑脊液7.5%(316/4 209)、分泌物4.4%(187/4 209)和胸腹腔积液、胆汁、肺泡灌洗液等其他类型标本4.8%(204/4 209)。多重耐药菌分离情况,甲氧西林耐药的金黄色葡萄球菌分离率逐年下降,但其他的多重耐药菌均有不同程度的上升,特别是碳青霉烯类耐药的肺炎克雷伯菌呈明显上升趋势。结论神经外科术后住院患者分离病原菌种类较多,主要以革兰阴性杆菌为主;但与其他科室分离种类有差异,不同种类病原菌耐药性差异较大,临床医师应根据自身科室病原菌分离特点及药敏分析报告正确合理的使用抗生素;并高度重视细菌耐药性的变化,规范操作,加强耐药菌的关注和用药情况,控制和减少院内感染的风险。
Objective To analyze the distribution and drug resistance of isolated pathogens in patients with neurological surgery in West China Hospital of Sichuan University,and provide evidence for clinical prevention and treatment.Methods Reviewed the clinical records and analyzed the data,and used WHONET 2018 software to analyze the distribution and drug susceptibility results of the isolated strains of the microbes collected by neurosurgery in 2014~2018.Results 4 209 strains of clinical,pathogens were Gram-negative bacteria,accounting for 77.6%(3 266/4 209),Gram-positive bacteria accounting for 19.9%(837/4 209),and fungi accounting for 2.5%(106/4 209).The top five pathogens with the highest amount of separation were Klebsiella pneumoniae 21.4%(899/4 209).Acinetobacter baumannii 15.5%(651/4 209),Pseudomonas aeruginosa 12.2%(515/4 209),large intestine Escherichia coli 8.6%(361/4 209) and Staphylococcus aureus 6.7%(281/4 209).According to the type of specimen,sputum specimen was 60.6%(2 551/4 209),blood specimen 12.0%(505/4 209),urine Liquid specimens 10.6%(446/4 209),cerebrospinal fluid specimens 7.5%(316/4 209),secretion specimens 4.4%(187/4 209) and other types of specimens such as pleural and ascites,bile,alveolar lavage fluid,etc.4.8%(204/4 209).Separation rate of multi-drug resistant bacteria,MRSA separation rate decreased year by year,but other multi-drug resistant bacteria had increased to varying degrees,especially the carbapenem-resistant Klebsiella pneumoniae isolation rate increased significantly trend.Conclusion There were many types of pathogens in hospitalized patients after neurosurgery,mainly Gram-negative bacilli.However,there were differences in the types of isolation from other departments,and the resistance of different kinds of pathogens was quite different.Clinicians should distinguish the characteristics of pathogens in their own departments.Drug susceptibility analysis reports the correct and rational use of antibiotics,and attaches great importance to changes in bacterial resistance,standardize op
作者
邓劲
王远芳
吴思颖
刘雅
康梅
DENG Jin;WANG Yuan-fang;WU Si-ying;LIU Ya;KANG Mei(Department of Clinical Mircrobiology of Experimental Medicine,West China Hospital,Sichuan University,Chengdu 610000,China)
出处
《现代检验医学杂志》
CAS
2019年第4期75-78,82,共5页
Journal of Modern Laboratory Medicine
关键词
术后感染
病原菌
耐药分析
神经外科
postoperative infection
pathogen
drug resistance analysis
neurosurgery
