185例妇科肿瘤患者医院感染病原菌分布特点及耐药性分析

摘要

目的：对185例妇科肿瘤患者医院感染病原菌的分布特点及耐药性进行分析。方法回顾性分析2014年1月～2015年9月期间我院收治的妇科肿瘤患者185例，送检的样品包括痰液、尿液、血液、粪便、分泌物等。结果共检出221株致病菌，其中革兰阴性菌共164株，铜绿假单胞菌所占比例明显高于其他病原菌（P＜0.05）。革兰阳性菌共40株，金黄色葡萄球菌所占比例明显高于其他病原菌（P＜0.05）。铜绿假单胞菌对哌拉西林的耐药率最高，大肠埃希菌对头孢西丁的耐药率最高，鲍曼不动杆菌对哌拉西林的耐药率最高。MRSA对青霉素G、氨苄西林、苯唑西林、头孢唑林等药物的耐药率最高，对万古霉素、利奈唑胺、替考拉宁的耐药率最低。MSSA对氨苄西林的耐药性最高，对苯唑西林、万古霉素、利奈唑胺、替考拉宁的耐药性最低。念珠菌对氟康唑的耐药率最高，对两性霉素B、5-氟胞嘧啶、酮康唑的耐药率最低。结论妇科肿瘤患者医院感染以革兰阴性菌为主，革兰阳性菌次之，细菌的耐药性比较严重，临床上要注意致病菌的耐药性，对妇科肿瘤患者加强营养及支持治疗，医护人员应对医院感染的管理加强力度，根据药敏结果正确、合理的使用抗菌药物，从而使耐药菌株的产生减少，医院感染发生率的降低。%Objective To analyze distribution characteristics and drug resistance of nosocomial infection pathogen of patients with gynecological tumors in 185 cases. Methods 185 patients with gynecological tumors who were admitted to our hospital from January 2014 to September 2015 were retrospectively analyzed. Submitted samples included sputum, urine, blood, feces, excretion and so on. Results 221 strains of pathogenic bacteria were detected. Of which, there were 164 strains of gram-negative bacteria. Proportion of pseudomonas aeruginosa was significantly larger than that of other pathogenic bacteria (P<0.05). There were 40 strains of gram-positive bacteria. Proportion of staphylococcus aureus was significantly larger than that of other pathogenic bacteria (P<0.05). For piperacillin, pseudomonas aeruginosa had the highest resistant rate. Escherichia coli were of the highest resistant rate for cefoxitin. For piperacillin, acinetobacter baumanii had the highest resistant rate. Methicillin resistant staphylococcus aureus (MRSA) were of the highest resistant rate for penicillin G, ampicillin, oxacillin, cefazolin, etc. al and of the lowest resistant rate for vancomycin, linezolid and teicoplanin. Methicillin sensitive staphylococcus aureus (MSSA) were of the highest resistant rate for ampicillin and of the lowest resistant rate for oxacillin, vancomycin, linezolid and teicoplanin. Monilia were of the highest resistant rate for fluconazole and of the lowest resistant rate for amphotericin B, 5-fluorocytosine and ketoconazole. Conclusion Nosocomial infections of patients with gynecological tumors were mainly are gram-negative bacteria followed by gram-positive bacteria. The drug resistance of bacteria is more serious and drug resistance of pathogens should be paid attention to in clinic. Patients with gynecological tumors should strengthen nutritive and supportive treatment, hospital staff should strengthen management of nosocomial infection and antibacterials should be correctly and properly used according to drug sensitivity results. All of these can reduce the productions of drug-resistant strains and the incidences of nosocomial infection.