神经内科医院感染患者的病原菌谱及耐药性研究

目的：通过分析本院神经内科医院感染患者的病原菌分布和耐药性，从而对医院感染的预防控制及其抗菌药物的选择和应用提供理论依据。方法：回顾性分析发生医院感染的74例患者的资料，对其采集的病原菌标本进行病原学检测和药敏试验。结果：医院感染率为4．87％，患者的医院感染部位中，呼吸道的感染概率最高，为68．92％，泌尿道次之，为17．57％。在送检率为67．57％的患者中检测出革兰阴性杆菌感染率为43．66％，革兰阳性球菌感染率为14．08％，真菌感染率为42．25％。革兰阴性杆菌对左氧氟沙星、亚胺培南和部分头孢类抗菌药物敏感性高；革兰阳性球菌对万古霉素、头孢噻肟、亚胺培南等抗菌药物敏感性高；真菌对酮康唑、氟康唑、两性霉素B等抗真菌药物较敏感性高。结论：神经内科医院最主要的感染部位是呼吸道，主要是真菌和革兰阴性杆菌感染，可以酮康唑作为真菌性感染治疗的首选抗菌药，而细菌性感染则首选左氧氟沙星和头孢噻肟等抗菌药物。

Study of Pathogenic Spectrum and Drug Resistance of Neurology Patients with Nosocomial infection

To provide a theoretical basis for the selection and application of prevention and control of hospi-tal infection and select antimicrobial drugs by analyzing pathogenic spectrum and drug resistance of Neurology patients with nosocomial infection .Methods ：A retrospective analysis the data of 74 cases of Neurology patients with nosocomial infection .Conduct of specimens collected from them about its pathogen detection and drug susceptibility testing of pathogens .Results：The hospital infection rate was 4 .87% .The probability of the site of infection in patients of respira-tory tract was 68 .92% and urinary tract was 17 .57% .Detection rate was 67 .57% .The rates of patients with Gram-negative bacilli infection ,Gram-positive cocci infection and fungal infection were 43 .66% ,14 .08% ,42 .25% ,respec-tively .Gram-negative bacilli was highly sensitive to levofloxacin and some cephalosporin antimicrobial ;Gram-positive cocci was highly sensitive to levofloxacin ,vancomycin and ampicillin/sulbactam antimicrobial ;Fungi was highly sensi-tive to ketoconazole ,fluconazole ,amphotericin B and other antifungal .Conclusion：The most important site of infection of Neurology patients was the respiratory tract .Fungi and Gram-negative bacilli infections ,were mainly pathogens .Ke-toconazole could be antimicrobial drugs for fungal infections and levofloxacin 、cefotaxime could be antimicrobial drugs for bacterial infections .