2011年神经内科住院感染患者病原菌分布及耐药谱型分析

目的了解我院神经内科住院感染患者病原菌的分布及病原菌对抗生素的耐药情况。方法分析2011年的神经内科住院感染患者病原学资料,药敏实验采用纸片扩散法,应用WHONT 5.5软件进行统计分析。结果神经内科住院感染患者以呼吸道感染为主,占67.19%,其次为泌尿道和血液感染。病原菌以革兰阴性杆菌为主,最常见的为大肠杆菌和肺炎克雷伯菌,其次为铜绿假单胞菌和鲍曼不动杆菌;革兰阳性球菌中以凝固酶阴性葡萄球菌最多。对革兰阴性杆菌敏感率大于70%的药物有亚胺培南、美罗培南、阿米卡星、头孢哌酮/舒巴坦及头孢吡肟。对革兰阳性球菌敏感性较好的抗生素有米诺环素、氯霉素,万古霉素、替考拉宁、利奈唑胺。结论神经内科住院感染患者病情较重,多重耐药株的出现给临床治疗带来困难,应该合理使用抗生素,减少耐药株的出现。

Surveillance of antimicrobial resistance and pathogen in department of neurology in 2011

Objective To investigate antimicrobial resistance and pathogen from neurology ward in 2011.Methods Clinical strains of patient in department of neurology were investigated.Antimicrobial susceptibility test was detected by Kirby-Bauer method.WHONET 5.5 software was used to analyze the data.Resultes Patients had a relatively high rate of hospital acquired infection.Respiratory was the most common affected,rate of isolated(67.19%).Urinary systems and blood were second,respectively.A total of 192 strains were isolated,129 of which were gram negative bacilli.The most common pathogen was E.coli and Klebsiella pneumoniae.P.aeruginosa and Acinetobacter baumanii was twice in department of neurology.The most active agents against gram negative bacilli was imipenim,meropenem,amikasin,cefoperazone / sulbactam cefepime The ratio of coagulation-negative-staphylococcus was most in gram positive cocci.The more active agents against gram positive cocci was minocycline and chloramphenicol,the most active of agents against gram positive cocci was vancomycin and teicoplanin and linezolid.Conclusions Prevalence of multiple-drug-resistant strains in department of neurology brought new challenge to clinician.Surveillance of antimicrobial agents play an important role in controlling hospital infection and rational use of antibiotic.