摘要
目的:分析医院骨科患者医院感染的发生情况及其病原学特征,为骨科患者医院感染的诊治提供参考。方法:选取2018年1月—2020年12月珠海市中西医结合医院骨科收治的6732例患者作为研究对象,统计和分析患者医院感染的发生情况及其病原学特征。结果:6732例骨科患者中发生医院感染的有63例(感染发生率为0.94%),感染部位主要为泌尿道(21例,占33.33%)和浅表切口(18例,占28.57%);63例感染患者标本中分离出病原菌80株,其中革兰阳性菌30株(占37.50%,以金黄色葡萄球菌为主)、革兰阴性菌48株(占60.00%,以铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌为主)、真菌2株(占2.50%);药敏结果显示,金黄色葡萄球菌对复方磺胺甲噁唑、呋喃妥因、利奈唑胺、喹努普汀-达福普汀、利福平、万古霉素的耐药率较低(<5.00%),对青霉素、头孢西丁、克林霉素、红霉素、苯唑西林的耐药率较高(>65.00%);铜绿假单胞菌对哌拉西林-他唑巴坦钠、环丙沙星、左氧氟沙星、美罗培南、头孢他啶、庆大霉素的耐药率较低(<30.00%),肺炎克雷伯菌对哌拉西林-他唑巴坦钠、左氧氟沙星、美罗培南、庆大霉素的耐药率较低(<30.00%),大肠埃希菌对哌拉西林-他唑巴坦钠、美罗培南、头孢他啶的耐药率较低(<30.00%),阴沟肠杆菌对除阿莫西林-克拉维酸钾和头孢唑林外的其他试验药物的耐药率均较低(<30.00%)。结论:医院骨科患者医院感染的发生率整体较低,金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌和阴沟肠杆菌是主要的致病菌,当前其耐药性并非很强,但临床在进行抗感染治疗时仍应尽量根据药敏结果合理选用抗菌药物,以提高治疗的准确性。
Objective:To analyze the occurrence and etiological characteristics of nosocomial infection among orthopedic patients in the hospital,and provide reference for the diagnosis and treatment of nosocomial infection in orthopedic patients.Methods:A total of 6732 patients admitted to Department of Orthopedics of Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to December 2020 were selected as study subjects,and the occurrence and etiological characteristics of nosocomial infection in patients were counted and analyzed.Results:Among 6732 orthopedic patients,63 patients had nosocomial infection(infection rate of 0.94%),and the infection sites were primarily urinary tract(21 patients,33.33%)and superficial incision(18 patients,28.57%);80strains of pathogenic bacteria were isolated from the specimens of 63 infected patients,including 30 strains of Grampositive bacteria(37.50%,primarily Staphylococcus aureus),48 strains of Gram-negative bacteria(60.00%,primarily Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli and Enterobacter cloacae)and 2 strains of fungi(2.50%).The results of drug susceptibility test showed that the resistance rate of Staphylococcus aureus to compound sulfamethoxazole,nitrofurantoin,linezolid,quinupristin-dalfopristin,rifampicin and vancomycin was low(less than5.00%),and the resistance rates of Staphylococcus aureus to penicillin,cefoxitin,clindamycin,erythromycin,oxacillin was high(greater than 65.00%).The resistance rate of Pseudomonas aeruginosa to piperacillin-tazobactam sodium,ciprofloxacin,levofloxacin,meropenem,ceftazidime,and gentamicin was low(less than 30.00%),the resistance rates of Klebsiella pneumoniae to piperacillin-tazobactam sodium,levofloxacin,meropenem and gentamicin was low(less than30.00%),the resistance rate of Escherichia coli to piperacillin-tazobactam sodium,meropenem,ceftazidime was low(less than 30.00%),and the resistance rate of Enterobacter cloacae to other investigational drugs except amoxicillinclavulanate potassium and cefazolin was low(less than 30.00%).Conclusion:The occurrence rate of nosocomial infection in orthopedic patients is low in the hospital.Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli and Enterobacter cloacae are the main pathogenic bacteria,and their drug resistance is not very strong at present.However,in clinical anti-infection treatment,antibacterial drugs should be selected rationally according to the drug susceptibility test results as far as possible to improve the accuracy of treatment.
作者
郭丹
姚晋林
蔡建丽
陈培生
郑浩渠
刘辰
GUO Dan;YAO Jin-lin;CAI Jian-li;CHEN Pei-sheng;ZHENG Hao-qu;LIU Chen(Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine,Zhuhai Guangdong 519000,China)
出处
《抗感染药学》
2022年第9期1268-1272,共5页
Anti-infection Pharmacy
关键词
医院感染
病原菌分布
耐药特点
nosocomial infection
distribution of pathogenic bacteria
drug resistance characteristics
作者简介
郭丹(1993—),女,住院医师,【电子邮箱】guodan446@163.com
