摘要
目的回顾分析普通外科患者不同感染部位的主要病原菌的分布及耐药性,为早期、合理开展经验性治疗提供参考。方法收集2012年1月-2016年1月医院普通外科收治的397例感染患者的感染组织、痰与腹腔引流及穿刺液标本,对感染患者标本进行病原菌的分离培养鉴定及药敏试验,观察分析病原菌的种类、分布及耐药性。结果 397例感染患者标本共培养出病原菌64种共计723株;其中感染组织中分离病原菌398株占55.05%,以大肠埃希菌、肺炎克雷伯菌、粪肠球菌为主;痰标本中共分离病原菌213株占29.46%,以肺炎克雷伯菌、铜绿假单胞菌及鲍氏不动杆菌为主;腹腔引流及穿刺液标本中共分离病原菌112株占15.49%,以大肠埃希菌和肺炎克雷伯菌为主;肺炎克雷伯菌、大肠埃希菌对亚胺培南及美罗培南均高度敏感;鲍氏不动杆菌多药耐药严重;粪肠球菌及屎肠球菌对万古霉素耐药率均为0。结论普通外科感染患者的病原菌以革兰阴性菌为主,对碳青霉烯类抗菌药物敏感,应依据病原菌分布特点及药敏试验结果合理选择抗菌药物。
OBJECTIVE To retrospectively investigate the distribution and drug resistance of the main pathogens of different infectious sites in patients of general surgery,so as to provide references for early and reasonable empirical treatment.METHODS The pathogens of the infected tissues,sputum,peritoneal drainage and puncture fluid of397 cases of infected patients were collected and identified in our hospital from Jan.2012 to Jan.2016.The samples of infected patients were used for isolation,culture,identification and drug sensitivity test.The pathogen typs,distribution and drug resistance were analyzed.RESULTS A total of 64 kinds of 723 strains of pathogens were cultured in 397 infected patients.Among them,398 strains were isolated from infected tissues,accounting for55.05%,which were mainly Escherichia coli,Klebsiella pneumoniae,and Enterococcus faecalis.There were 213 strains of pathogens isolated from the sputum samples,and mainly were Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii.Totally 112 strains of pathogens were isolated from intraperitoneal drainage and puncture fluid samples,and mainly were Escherichia coli and Klebsiella pneumoniae.Klebsiella pneumoniae and Escherichia coli were highly sensitive to imipenem and meropenem.Acinetobacter baumannii was with highly multiple drug resistance.The resistant rates of Enterococcus faecalis and Enterococcus faeciumto vancomycin were both 0.CONCLUSION The pathogenic bacteria of patients with general surgical infection are mainly gram-negative bacteria,which are sensitive to carbapenem antibiotics.The rational selection of antimicro-bial agents should be based on the distribution characteristics of pathogenic bacteria and the results of drug sensitivity test.
作者
滕达
荆颖
卫勃
李松岩
郭欣
谢天宇
杜晓辉
罗燕萍
TENG Da;JING Ying;WEI Bo;LI Song-yan;GUO Xin;XIE Tian-yu;DU Xiao-hui;LUO Yan-ping(Chinese PLA General Hospital, Beijing 100853, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第7期1041-1044,共4页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(61471397)
关键词
普通外科
医院感染
病原菌分布
耐药性
General surgery
Nosocomial infection
Distribution of pathogens
Drug resistance
