高压氧病区脑损害患者分离病原菌及耐药性

目的了解高压氧病区脑损害患者分离的病原菌及耐药性,为临床抗感染治疗提供参考。方法对2013年1月—2014年12月某院高压氧病区975例脑损害患者的血、痰、尿等标本的细菌培养及药敏试验结果进行回顾性分析。结果共检出病原菌1 328株,其中革兰阴性菌877株,占66.04%;革兰阳性菌213株,占16.04%;真菌238株,占17.92%。分离居前5位的病原菌分别为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌和白假丝酵母菌。标本主要来源于痰和尿,分别占58.59%、35.24%。肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌对亚胺培南的耐药率分别为16.67%、81.82%、82.44%、4.65%。革兰阳性菌未发现耐万古霉素菌株,粪肠球菌对绝大多数所测试抗菌药物的耐药率均低于屎肠球菌。结论高压氧病区脑损害患者以呼吸系统、泌尿系统感染为主,病原菌以革兰阴性菌为主。

Isolation and antimicrobial resistance of pathogens isolated from patients with brain damage in hyperbaric oxygenation department

ObjectiveTo study the isolation and antimicrobial resistance of pathogens isolated from patients with brain damage in hyperbaric oxygenation department, so as to provide reference for clinical anti infective treatment. MethodsBacterial culture and antimicrobial susceptibility testing results of pathogens isolated from blood, sputum, and urine specimens of 975 patients with brain damage in the hyperbaric oxygenation department of a hospital between January 2013 and December 2014 were analyzed retrospectively. ResultsA total of 1 328 strains of pathogens were detected, 877 (66.04%) of which were gram negative bacteria, 213(16.04%) were gram positive bacteria, and 238(17.92%) were fungi. The top five isolated pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, and Candida albicans. Specimens mainly isolated from sputum and urine, accounting for 58.59% and 35.24% respectively, resistance rates of Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Escherichia coli to imipenem were 16.67%, 81.82%, 82.44%, and 4.65% respectively. Vancomycin resistant strains was not found among gram positive bacteria, resistance rates of Enterococcus faecalis to most antimicrobial agents were lower than those of Enterococcus faecium. ConclusionRespiratory and urinary tract infection account for most of the infection in patients with brain damage in hyperbaric oxygenation department, gram negative bacteria are the predominant pathogens causing infection.