普通外科患者术后感染病原菌分布及耐药性分析

摘要

Objective To analyze the spectrum and drug resistance of the pathogens in patients with postoperative infection of general surgery, and provide the basis for the rational use of antibiotics. Methods The pathogen identification and drug susceptibility test were carried out in our hospital from January 2013 to January 2016, and the source, spectrum and drug resistance of pathogens were analyzed statistically. Results A total of 589 strains were isolated from 554 patients. They were mainly from tissues (41.52％), respiratory specimens [including sputum (24.55％), blood (9.75％), catheters (5.06％), peritoneal drainage and puncture fluid (4.33％), urine (4.15％), and pus (3.79％)]. Gram negative bacteria accounted for 74.19％ of the isolated pathogens, with gram positive bacteria of 20.03％ and fungi of 5.77％. Among them, Klebsiella pneumoniae and Escherichia coli were highly sensitive to imipenem and meropenem (sensibility ＞ 95％). Pseudomonas aeruginosa was sensitive to carbapenem antibiotics (sensibility ＞ 85％). However, acinetobacter baumannii presented drug resistance to a variety of antibiotics (drug resistance rate ＞ 50％). Enterococcus faecalis and Enterococcus faecium were highly sensitive to vancomycin (drug resistance rate of 0％). Conclusion The surgical infection is predominantly caused by gram negative bacteria which can be treated with carbapenem antibiotics, such as meropenem.%目的 回顾分析普通外科术后感染患者的主要病原菌来源、分布及耐药性,为临床合理应用抗菌药物提供依据.方法对我院2013年1月-2016年1月普通外科术后感染患者的送检标本进行病原菌的分离培养鉴定及药敏试验,对病原菌的来源、种类、分布及耐药情况做统计分析.结果554例感染患者标本共培养出病原菌63种,共计589株.标本主要来自组织(41.52％)、呼吸道标本(含痰)(24.55％)、血液(9.75％)、导尿管(5.06％)、腹腔引流及穿刺液(4.33％)、尿液(4.15％)、脓液(3.79％)等.分离病原菌以革兰阴性菌(G-)为主,占74.19％,革兰阳性菌(G+)占20.03％,真菌占5.77％.其中肺炎克雷伯菌、大肠埃希菌对亚胺培南及美罗培南均高度敏感(敏感性均＞95％);铜绿假单胞菌对碳青霉烯类抗生素较敏感(敏感性＞ 85％),但鲍曼不动杆菌对多种抗生素耐药(耐药率均＞ 50％);革兰阳性菌中粪肠球菌、屎肠球菌对万古霉素均高度敏感(耐药率0).结论普通外科感染中革兰阴性杆菌占绝对优势,治疗可以碳青霉烯类抗菌药物如美罗培南为主.