外科感染常见菌群分布及致病菌耐药性监测

目的了解武汉地区外科感染致病菌的菌群分布及其对抗生素的耐药现状。方法将武汉地区１３所医院所做的抗生素对外科分离菌的抑菌结果即抑菌圈直径输入计算机。采用“ＷＨＯＮＥＴ３”软件进行统计和分析,根据１９９３年美国临床实验室标准委员会（ＮＣＣＬＳ）发布的标准判断细菌耐药性。结果１９９６年共收集外科感染菌株９５７株。金黄色葡萄球菌、铜绿假单胞菌、大肠杆菌和凝固酶阴性葡萄球菌（ＣＮＳ）是主要菌种。１２４％的金黄色葡萄球菌对苯唑西林耐药,对其它抗生素的耐药性也有所增加。肠杆菌科菌株对氨苄西林的耐药率＞７５％,克雷伯菌属对此的耐药率达９３％。大多数革蓝阴性（Ｇ－）杆菌,包括肠杆菌科和铜绿假单胞菌对亚胺配南、头孢他啶、阿米卡星和环丙沙星敏感。结论在外科领域开展细菌耐药性监测工作,并随时掌握细菌耐药动态具有重要的临床意义     

ICU病房呼吸道病原及耐药性的分析

目的：分析重症监护病房（ICU）呼吸道感染的流行病学及细菌耐药情况，为临床防治提供依据。方法：对重症监护病房1998年12月－2000年12月由呼吸道分泌物所分离的细菌菌株及细菌耐药性进行回顾性调查，结果加以整理分析，结果：革兰阴性杆菌占67．3％，仍以铜绿假单胞菌为主（53．2％），金黄色葡萄球菌中，耐甲氧西林金黄色葡萄球菌（MRSA）占29．7％，表面葡萄球菌有上升趋势，在细菌耐药性方面，革兰阴性杆菌对头孢吡肟，泰能，舒普深耐药率最低，MRSA对万古霉素仍敏感，无一例耐药。结论：ICU获得性感染中仍以革兰阴性杆菌为主，革兰阳性球菌也在增加，应受到重视。重症监护病房抗菌药物耐药的出现使治疗某些感染变得非常困难，危及生命，及时掌握病原菌及耐药性的最新动态，指导临床医生正确选用抗生素，意义重大。     

重症急性胰腺炎术后胰腺感染病原菌及药物敏感性分析

目的分析因重症急性胰腺炎行引流手术且术后合并胰腺感染患者的细菌学及药敏报告,为重症急性胰腺炎术后感染的抗生素应用提供临床参考。方法收集2003年1月—2006年4月间86例重症急性胰腺炎术后患者腹腔引流物标本,对标本进行细菌培养,检测菌株对抗生素的耐药情况。结果86例患者中共分离出276株细菌,检出率分别为阴沟肠杆菌（12．3％）、铜绿假单胞菌（10．9％）、金黄色葡萄球菌（9．4％）、其他葡萄球菌（9．4％）、D群链球菌（9．4％）、粪肠球菌（8．7％）、大肠埃希菌（8．7％）、表皮葡萄球菌（6．5％）、肺炎克雷伯菌（4．3％）、屎肠球菌（4．3％）。药敏分析及耐药试验表明重症急性胰腺炎术后胰腺感染耐药严重,对于革兰阳性球菌,万古霉素和替考拉宁尚保持了较好的抗菌活性,对于革兰阴性杆菌仅碳青酶烯类抗生素对其存在较好的抗菌活性。结论对重症急性胰腺炎术后胰腺感染患者,大部分菌株广泛耐药,临床上应依据细菌药物敏感性结果,不断调整抗生素。     

外科感染患者细菌分布及耐药性的单中心研究

目的 分析外科感染患者细菌分布及其对常用抗菌药物的耐药性,为外科感染的规范化治疗提供依据.方法 回顾性调查分析2008年1月至201 1年12月外科感染患者送检标本的细菌鉴定及药物敏感性检测结果.结果 3257份临床标本共分离菌株3829株,革兰阴性杆菌占62.4％(以大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌为主);革兰阳性球菌占37.6％(以肠球菌、金黄色葡萄球菌及凝固酶阴性葡萄球菌为主),其中金黄色葡萄球菌、粪肠球菌检出率呈升高趋势.大肠埃希菌及肺炎克雷伯菌对亚胺培南、阿米卡星、哌拉西林/他唑巴坦等抗菌药物耐药率较低;铜绿假单胞菌和鲍曼不动杆菌对头孢类、碳青霉烯类及喹诺酮类抗菌药物耐药率较高,呈多药耐药性;所有葡萄球菌、粪肠球菌对万古霉素和替考拉宁敏感(100％),但耐万古霉素屎肠球菌检出率呈上升趋势(1.9％～7.5％).产超广谱β-内酰胺酶(ESBL)大肠埃希菌检出率为45.6％ ～61.5％;产ESBL肺炎克雷伯菌检出率呈波动表现;耐甲氧西林金黄色葡萄球菌检出率较高(21.1％ ～55.8％),耐甲氧西林表皮葡萄球菌检出率明显高于其他阳性球菌.结论 我院外科临床感染病原菌以革兰阴性杆菌为主,临床分离细菌耐药现象较为普遍,铜绿假单胞菌和鲍曼不动杆菌药物耐药率较高.     

外科感染常见病原菌及耐药现状

1外科感染常见病原菌20世纪60年代以前,外科感染病原菌以金黄色葡萄球菌和化脓性链球菌为主。20世纪70年代以后,革兰阳性(G )球菌的占有比例有所下降,尤其是化脓性链球菌明显减少,而革兰阴性(G-)杆菌,主要是以大肠埃希菌为代表的肠道杆菌科细菌,则相对增多;两类细菌的比值大约是3∶7。到了20世纪90年代,国内外都注意到G 球菌引起的感染又有增多趋势。中国细菌耐药监测研究(9个城市13~18所医院)结果显示,G 球菌所占比例在1999年为28.8%,2001年为33.5%,2003年为38.2%[1-2]。湖北地区15所医院报告,外科感染病原菌中G 球菌在1998-1999年占36.5…     

外科患者革兰阳性球菌感染的抗菌药物治疗

一、革兰阳性（G^＋）球菌感染——咄咄逼人的威胁 在20世纪60年代以前，G^＋球菌（主要是金黄色葡萄球菌和化脓性链球菌）一直是外科感染的主要致病菌。随着青霉素、四环素、大环内酯类等抗生素的开发和广泛应用，到了20世纪60、70年代，G^＋球菌在外科感染病原菌中的优势地位逐渐被G^-杆菌所取代。然而这一趋势在20世纪80年代又发生了逆转，20世纪90年代以后，G^＋球菌卷土重来的趋势已很明显。欧洲一项多中心研究显示，1973～1976年，在医院感染中G^＋球菌和G^-杆菌各自占有的份额是29％和71％；在80年代中期基本持平，到了1993～1994年已变成69％和31％。在我国，这一变化虽然相对滞后，但趋势是相同的。中国细菌耐药监测研究（9个城市，13～18所医院）结果显示，G^＋球菌所占份额在1999年为28．8％，2001年为33．5％，2003年为38．2％。湖北地区15所医院报告，外科感染病原菌中G^＋球菌在1998～1999年占36．5％，2002年上升到39．4％。解放军三○四医院的报告显示，G^＋球菌在2003年占47．5％，而在烧伤感染分离菌中则高达52．6％。     

普通外科重症加强治疗病房获得性感染的耐药性监测

目的监控外科重症加强治疗病房（SICU）中医院获得性感染的病原菌耐药性,指导临床防治。方法监测分析我院SICU2001年1月至2004年12月间医院获得性感染的情况。结果平均感染率为11．3％,常见感染部位是呼吸道（30．9％）、腹腔（29．0％）、血液（9．7％）和胆道（7．2％）;常见病原菌是铜绿假单胞菌（11．6％）、凝固酶阴性葡萄球菌（11．1％）、白色念珠菌（9．7％）。大肠埃希菌和肺炎克雷伯菌中超广谱β内酰胺酶（ESBLs）产生株的检出率分别为66．2％和58．5％;耐甲氧西林的金黄色葡萄球菌（MRSA）和凝固酶阴性葡萄球菌（MRCNS）检出率分别是94．7％和88．2％。碳青霉烯类对肠杆菌的抗菌活性最强,非发酵菌耐药严重;万古霉素、替考拉宁对革兰阳性球菌活性最强,二性霉素B对真菌抗菌活性最强。结论SICU医院获得性感染耐药问题严重,不同感染部位的病原菌各有特点,建立感染监控机制,掌握医院获得性感染的耐药性变化是有效预防和治疗的关键。     

感染性眼病的病原菌分布及耐药性分析

目的探讨感染性眼病的主要病原菌分布及其耐药性。方法回顾性分析2009年1月_2011年12月天津市眼科医院眼病感染性样本2397份,对其进行细菌、真菌和阿米巴的培养与鉴定,分析病原菌的分布及其耐药性。结果在2397份送检样本中,培养阳性799份,阳性率为33．33％。其中,细菌培养阳性701份,占87．73％（701／799）;真菌培养阳性95份,占11．89％（95／799）;阿米巴培养阳性3份,占0．36％（3／799）。701株细菌中,革兰阳性球菌占76．03％（533／701）,表皮葡萄球菌所占比例最高为46．15％（246／533）;革兰阴性杆菌占19．69％（138／701）,以非发酵菌居多,其中铜绿假单胞菌占28．98％（40／138）;革兰阳性杆菌占4．28％（30／701）。95株真菌以丝状真菌为主,占97．89％（93／95）,最常见的丝状真菌为镰刀菌属（54／95,56．84％）、链格孢霉（13／95,13．68％）和曲霉菌属（17／95,17．88％）。体外药敏试验结果显示,表皮葡萄球菌对米诺环素和万古霉素的耐药率为0;铜绿假单胞菌对氨苄西林／舒巴坦、复方磺胺甲嗯唑和头孢噻肟的耐药率达100％,对阿米卡星、多黏菌素E、美罗培南、哌拉西林／他巴唑坦、妥布霉素的耐药率为0;真菌中茄病镰刀菌对两性霉素B的耐药率较低。结论细菌是感染性眼病的主要病原菌,其中以革兰阳性球菌最常见,其对万古霉素敏感;眼部致病真菌最常见的是镰刀菌属,其对两性霉素B敏感。     

1993～1996年1312株烧伤感染菌的耐药性调查分析

目的长期监测烧伤中心病房感染细菌的菌种和耐药率，以指导临床用药。方法应用ＶＩＴＥＫ－ＡＭＳ系统检测１９９３～１９９６年我院烧伤中心１３１２株细菌的检出率及细菌耐药性变化。结果４年来检出菌种中铜绿假单胞菌居首位，检出率为３１．１６％～４８．４８％；金黄色葡萄球菌次之，检出率为１１．４８％～１６．１６％；其后为粪肠球菌、阴沟肠杆菌及不动杆菌等，但各年度位次不一。抗生素对铜绿假单胞菌敏感率超过５０％者，１９９３年为７种，１９９４～１９９６年下降为４种。万古霉素对金黄色葡萄球菌（ＭＲ－ＳＡ）为１００％敏感，而头孢菌素及喹喏铜类，对金葡菌均高度耐药（７９％～８６％）。结论长期监测烧伤中心致病菌种的变更，细菌药敏变化及选择应用敏感抗生素非常重要。     

连续三年尿路感染菌谱监测及耐药性分析

目的对近3年来尿路感染的菌谱及细菌耐药性进行调查分析，指导临床合理用药。方法收集从我院尿路感染患者尿液标本中分离的828株病原菌进行细菌鉴定及药敏试验（Kirby-Bauer法），并对革兰阴性杆菌进行超广谱8内酰胺酶（ESBLs）的检测。结果近3年尿路感染以革兰阴性杆菌为主，占68．24％，列前3位的是大肠埃希菌（56．64％），粪肠球菌（10．1）2％）、真菌（8．56％）。2004年至2006年超广谱8内酰胺酶大肠埃希氏菌比例呈上升趋势（分别占7．59％、23．2％、22．04％）。产酶大肠埃希菌对亚胺培南的耐药率是1．4％，对呋喃妥因的耐药率是23．21％，对头孢类耐药率59．38％～97．26％，对复方新诺明耐药率是95．31％。非产酶大肠埃希菌对亚胺培南的耐药率是0．3％，对呋喃妥因的耐药率是18．14％，对头孢类耐药率从8．87％～31．1）6％不等，对复方新诺明耐药率是72．62％。细菌对各种抗生素有不同程度的耐药性，表现为多重耐药。结论革兰阴性杆菌为尿路感染的主要病原菌，且产超广谱β内酰胺酶的大肠埃希菌呈上升趋势，定期监测尿路感染细菌谱及耐药性变化对于指导临床合理应用抗生素具有十分重要的意义。     

Antimicrobial resistance of Pseudomonas aeruginosa strains isolated from surgical infections in a 7-year period at a general hospital in Venezuela

BACKGROUND: By definition, the term "surgical infection" implies that surgery plays the major role in therapy, whereas antimicrobial chemotherapy is only supplementary. Despite this view, the efficacy of such drugs is relevant, and for this reason, drug activity surveillance is necessary, especially for opportunistic and nosocomial pathogens such as Pseudomonas aeruginosa. We evaluated bacterial isolates from patients with suspected surgical infections in a hospital of Caracas, Venezuela (West General Hospital) between 1997 and 2003. METHODS: Clinical samples were processed and identified with standard cultures and biochemical tests. The antimicrobial susceptibility of the isolates in vitro was assessed by an agar disk diffusion method using Mueller-Hinton agar, as recommended by the National Committee for Clinical Laboratory Standards (now the Clinical and Laboratory Standards Institute). Isolates were tested against 22 drugs, including piperacillin, ceftazidime, cefoperazone, amikacin, gentamicin, ciprofloxacin, meropenem, and imipenem. RESULTS: From a total of 16,287 bacterial strains isolated from surgical infections during the study period, 243 (1.5%) were P. aeruginosa. Of this total, 30.9% were resistant to gentamicin, 26.3% to tobramicin, 23.0% to cefoperazone, 22.8% to piperacillin, 22.5% to ciprofloxacin, 17.6% to amikacin, 13.6% to imipenem, and 12.9% to meropenem. The best antimicrobial activity was observed with cefepime (90.1% susceptible strains, 1.9% intermediate resistance, and 8.0% resistant strains) and aztreonam (77.7% susceptible strains, 15.2% intermediate resistance, and 7.1% resistant strains). CONCLUSIONS: In our setting, cefepime is most active against strains of P. aeruginosa. In comparison with third-generation cephalosporins, cefepime may be less likely to induce resistance. Surveillance of antimicrobial activity should be done periodically to guide therapy of surgical infections.     

Pseudomonas aeruginosa bacteraemia in an academic hospital in South Africa

OBJECTIVES: The aim of the study was to determine the clinical manifestations, outcome of and prognostic factors associated with Pseudomonas aeruginosa bacteraemia at Chris Hani Baragwanath Hospital, Johannesburg, during the period 1998 - 1999, to describe and quantify resistance to antipseudomonal drugs, to characterise bacteraemic isolates, and to investigate the clustering and genotype distribution of drug-susceptible and multiply-resistant strains in the hospital. METHODS: Clinical and laboratory investigations, culture and antimicrobial susceptibility testing were performed. Bacteraemic isolates were typed by endonuclease macrorestriction. Those with > or = 97% band pattern similarity were assigned genotype status. RESULTS: Of 91 P. aeruginosa blood isolates, 52 (57.1%) were nosocomially acquired. Underlying conditions associated with episodes were burns in 24 (28%) and HIV infection in 21 (24%). Multidrug resistance was present in 14 (15.4%) of isolates from 91 episodes. In 79 episodes where the outcome was known, 37 (46.8%) of the patients died. Case fatality rates were 75% in adults and 25% in children. Being a child, receiving appropriate antimicrobial treatment and admission to a specialised care unit were significantly associated with improved prognosis. CONCLUSION: P. aeruginosa bacteraemia was associated with outbreaks caused by two multiply-resistant genotypes. Eighteen antimicrobial-susceptible isolates from bacteraemic episodes in paediatric wards, 9 in HIV-seropositive children, could be linked to small outbreaks in both hospitalised and community-based children.     

Survey of resistance of Pseudomonas aeruginosa from UK patients with cystic fibrosis to six commonly prescribed antimicrobial agents

BACKGROUND: Respiratory infection with Pseudomonas aeruginosa is very common in patients with cystic fibrosis (CF) but antimicrobial resistance rates of CF isolates across the UK are largely unknown. METHODS: The susceptibility of 417 CF patient isolates of P aeruginosa from 17 hospitals to six commonly prescribed antibiotics were examined. Isolates were tested by an agar break point dilution method and E-tests according to British Society of Antimicrobial Chemotherapy guidelines. Genotyping of isolates was performed by XbaI DNA macrorestriction and pulsed field gel electrophoresis. RESULTS: 38% of isolates were susceptible to all of the agents tested; almost half were resistant to gentamicin compared with ceftazidime (39%), piperacillin (32%), ciprofloxacin (30%), tobramycin (10%), and colistin (3%). Approximately 40% were resistant to two or more compounds with ceftazidime in combination with gentamicin, piperacillin or ciprofloxacin being the most common cross resistances. Resistance rates were generally similar to those reported recently from the USA and Germany. A selection of resistant isolates proved to be predominantly genotypically distinct by XbaI DNA macrorestriction but six pairs from three centres had similar genotypes. CONCLUSIONS: The level of resistance to front line antipseudomonal agents, with the exception of colistin, is disturbingly high. The prudent use of antimicrobial drugs and closer monitoring of accumulation of resistant strain populations should be actively considered.     

住院患者肺炎克雷伯菌血流感染的临床特点与耐药分析

目的了解住院患者肺炎克雷伯菌血流感染的临床特点、预后及耐药情况,为临床经验性治疗提供依据。 方法回顾性分析本院2011年1月至2015年1月收治的肺炎克雷伯菌血流感染者的临床资料、抗菌药物使用和实验室检查结果。细菌鉴定和药敏试验采用Vitek-2 Compact系统和配套鉴定及药敏卡,应用Whonet 5.6进行耐药分析。 结果75例入组者主要分布科室为ICU、普外科、血液科和急诊内科,平均年龄63岁,合并多种基础疾病,其中以肺部感染（46.67%）、颅脑疾病（30.67%）、糖尿病（29.33%）、胆道疾病（18.67%）、低血红蛋白症（18.67%）、肾功能不全（14.67%）和实体器官肿瘤（13.33%）多见,发生脓毒血症、感染性休克患者15例（20.00%）。药敏试验结果显示,75株肺炎克雷伯菌产ESBLs占42.67%,对美罗培南、亚胺培南和厄他培南的耐药率分别为6.67%、10.67%和8.00%,对哌拉西林/他唑巴坦（16.00%）和阿米卡星（10.67%）耐药率较低（均< 20%）。入组患者病死率为25.33%,MDR组患者病死率（29.73%）高于非MDR组（21.05%）。感染性休克、入住ICU为患者死亡的独立危险因素（χ² = 18.91、P = 0.025,χ² = 6.63,P = 0.01）。 结论肺炎克雷伯菌血流感染常合并多种基础疾病,且病死率高,碳青霉烯类耐药菌的出现应引起重视。     

Profile of microorganisms and antimicrobial resistance at a tertiary care referral burn centre in Iran: emergence of Citrobacter freundii as a common microorganism

Infection and antimicrobial resistance are important issues in severe burn. The aims of this prospective study were to investigate the profile of microorganisms and resistance to antimicrobial agents in a tertiary referral burn centre; 113 people aged >10 years, with partial- or full-thickness burns, were included in the study. A total of 733 samples including 275 swabs, 164 tissue biopsies, 258 urine samples, 26 blood samples and 10 sputum samples were collected, from which 124 microorganisms were isolated. Pseudomonas aeruginosa and Citrobacter spp were the most prevalent isolates (57.3% and 35.5%, respectively); 95.5% of Citrobacter. isolates were Citrobacter freundii. Antibiogram results obtained from 15 antimicrobial agents demonstrated that imipenem was the most effective agent against P. aeruginosa, followed by ciprofloxacin and piperacillin/tazobactam (67.9%, 43% and 37.5% sensitive, respectively). At least 60% of all Citrobacter isolates were sensitive to various antimicrobial agents, the highest sensitivity being obtained by ceftazidime and cefepime (81.6% and 78.4%, respectively). Sensitivity of P. aeruginosa isolates to the agents of each antimicrobial class was significantly different (p<0.001). The incidence of C. freundii and the resistance of P. aeruginosa to anti-pseudomonas agents were exceptionally high.     

Emerging infections with community-associated methicillin-resistant Staphylococcus aureus in outpatients at an Army Community Hospital

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection typically occurs in chronically ill patients requiring long-term antimicrobial therapy or hospitalization. However, community-associated MRSA (CA-MRSA) necrotizing soft tissue infections seem to be increasing in incidence. Our aim was to describe the incidence and microbiologic characteristics of CA-MRSA isolates collected at an army community hospital. METHODS: We report a retrospective review of MRSA isolates identified during 1998-2003 at the microbiology laboratory of Moncrief Army Community Hospital that serves a community of approximately 40,000 transient residents yearly in Fort Jackson, South Carolina. We evaluated the incidence of MRSA in our laboratory during 1998-2003. For MRSA isolates from 2003, we evaluated antimicrobial susceptibility patterns. Six selected isolates were evaluated by molecular typing, resistance gene analysis, and toxin analysis. RESULTS: During 1998-2003, 241 (23%) of 1041 S. aureus isolates identified at the hospital microbiology laboratory were resistant to methicillin. Of these 241 MRSA isolates, 223 were cultured from outpatients. The incidence of MRSA in our population increased from 12% of S. aureus isolates in 1998 to 43% in 2003. In 2003, MRSA was cultured from 76 different patients. Isolates of MRSA were often resistant to erythromycin (91%), although resistance to other agents was less common: Ciprofloxacin (14%), levofloxacin (14%), clindamycin (3%), tetracycline (3%), and trimethoprim sulfamethoxazole (1%). No isolates were resistant to vancomycin, gentamicin, nitrofurantoin, or rifampin. Six CA-MRSA isolates were compared by pulsed-field gel electrophoresis (PFGE). Five were PFGE type USA300, and one was PFGE type USA100, based on the U.S. Centers for Disease Control and Prevention (CDC) classification scheme. The five USA300 isolates carried SCCmec type IV, and the USA100 carried SCCmec II. None of the isolates were positive by PCR for genes encoding enterotoxins A-E and H, or toxic shock syndrome toxin (TSST-1), but the five USA300 isolates carried the gene coding for Panton-Valentine leukocidin toxin. CONCLUSIONS: The incidence of MRSA at our institution is increasing. Isolates of MRSA show resistance patterns and microbiologic characteristics consistent with CA-MRSA isolates from the United States. Clinicians should consider the possibility of CA-MRSA in patients with soft-tissue infections who do not respond to initial therapy with beta-lactam antimicrobial agents.     

Staphylococci as uropathogens-frequency of isolation in hospitalized patients and sensitivity to antimicrobial agents

For a period of 24 months (1997-1999) were isolated 266 clinically significant staphylococcal strains, S. aureus, 36 (13.5%) and 230 (86.5%) coagulase negative staphylococci (CNS) from urines of hospitalised patients (over 14 years) with UTI. The most frequently isolated strains from CNS was S. haemolyicus, 110 (47.8) strains, followed by S. saprophyticus 47 (20.4%) strains and S. epidermidis 18 (7.8%). The susceptibility of the isolates to 13 antimicrobial agents was determined by agar dilution method (NCCLS). From the isolated 36 strains S. aureus, 24 were sensitive and 12 were resistant to methicillin. From 230 CNS, 105 strains showed sensitivity and 125 strains resistance to methicillin. All staphylococci were sensitive to vancomycin and most of them (over 95%) to amikacin and rifampin. It was established a considerable difference between the sensitivity of methicillin-sensitive and methicillin-resistant staphylococci. The established resistance accompanied with high rate percentage methicillin resistance requires careful consideration to antimicrobial therapy of staphylococcal urinary tract infections (UTI).     

Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition

After publication of the initial version of the Japanese guidelines for urological surgery in 2007, new surgical techniques have been introduced. Furthermore, several important issues, such as criteria for use of single‐dose antimicrobial prophylaxis and control of hospitalized infection, were also established, which led to alterations of the methods used for antimicrobial prophylaxis as well as perioperative management. The purpose of antimicrobial prophylaxis is to protect the surgical wound from contamination by normal bacterial flora. Antimicrobial prophylaxis should be based on penicillins with beta‐lactamase inhibitors, or first‐ or second‐generation cephalosporins, though penicillins without beta‐lactamase inhibitors should not be prescribed because of the high prevalence of antimicrobial resistance. As an adequate intratissue concentration of the antimicrobial at the surgical site should be accomplished by the time of initiation of surgery, antimicrobial prophylaxis should be started up to 30 min before beginning the operation. Antimicrobial prophylaxis should be terminated within 24 h in clean and clean‐contaminated surgery, and within 2 days of surgery using the bowels, because a longer duration is a risk factor for surgical site infection development. Importantly, possible risk factors for surgical site infections include the antimicrobial prophylaxis methodology used as well as others, such as duration of preoperative hospitalization, hand washing, the American Society of Anesthesiologists score, diabetes and smoking history. These guidelines are to be applied only for preoperatively non‐infected low‐risk patients. In cases with preoperative infection or bacteriuria that can cause a surgical site infection or urinary tract infection after surgery, patients must receive adequate preoperative treatment based on the individual situation.     

2006-2010年医院血流感染病原菌的分布与耐药性监测分析

目的:分析我院血流感染病原菌的分布特点及耐药性变迁,为临床抗感染的预防与控制提供实验室依据.方法:收集解放军总医院第一附属医院2006年1月-2010年12月临床分离自血液的725株不重复细菌,细菌鉴定及药敏试验采用全自动细菌生化分析仪(VITEK2 COMPACT).根据美国临床实验室标准化协会(CLSI)2010年...