[1]邓 劲,王远芳,吴思颖,等.2014～2018年四川大学华西医院神经外科住院患者术后病原菌分布特点及耐药分析[J].现代检验医学杂志,2019,34(04):75-78.[doi:10.3969/j.issn.1671-7414.2019.04.018]
　DENG Jin,WANG Yuan-fang,WU Si-ying,et al.Distribution Characteristics and Drug Resistance of Postoperative Pathogens in Hospitalized Patients with Neurosurgery in West China Hospital of Sichuan University in 2014～2018[J].Journal of Modern Laboratory Medicine,2019,34(04):75-78.[doi:10.3969/j.issn.1671-7414.2019.04.018]
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2014～2018年四川大学华西医院神经外科住院患者术后病原菌分布特点及耐药分析()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年04期
页码:
75-78
栏目:
论著
出版日期:
2019-08-20

文章信息/Info

Title:
Distribution Characteristics and Drug Resistance of Postoperative Pathogens in Hospitalized Patients with Neurosurgery in West China Hospital of Sichuan University in 2014～2018
文章编号:
1671-7414(2019)04-075-05
作者:
邓 劲,王远芳,吴思颖,刘 雅,康 梅
(四川大学华西医院实验医学科临床微生物室,成都 610000)
Author(s):
DENG Jin,WANG Yuan-fang,WU Si-ying,LIU Ya,KANG Mei
(Department of Clinical Mircrobiology of Experimental Medicine, West China Hospital,Sichuan University,Chengdu 610000,China)
关键词:
术后感染;  病原菌;  耐药分析;  神经外科
分类号:
R446.5
DOI:
10.3969/j.issn.1671-7414.2019.04.018
文献标志码:
A
摘要:
目的 分析四川大学华西医院神经外科术后感染患者分离病原菌分布及耐药情况,为临床预防与治疗提供依据。方法 回顾临床病历纳入分析数据,采用WHONET 2018软件分析2014～2018年神经外科送检微生物标本分离菌株的分布情况和药敏结果。结果 4 209株临床病原菌以革兰阴性菌为主,占77.6%(3 266/4 209),革兰阳性菌占19.9%(837/4 209),真菌占2.5%(106/4209)。分离量最多的病原菌前五位分别是肺炎克雷伯菌21.4%(899/4 209)、鲍曼不动杆菌15.5%(651/4 209)、铜绿假单胞菌12.2%(515/4 209)、大肠埃希菌8.6%(361/4 209)和金黄色葡萄球菌6.7%(281/4 209); 按标本类型分,痰液60.6%(2 551/4 209)、血液12.0%(505/4 209)、尿液10.6%(446/4 209)、脑脊液7.5%(316/4 209)、分泌物4.4%(187/4 209)和胸腹腔积液、胆汁、肺泡灌洗液等其他类型标本4.8%(204/4 209)。多重耐药菌分离情况,甲氧西林耐药的金黄色葡萄球菌分离率逐年下降,但其他的多重耐药菌均有不同程度的上升,特别是碳青霉烯类耐药的肺炎克雷伯菌呈明显上升趋势。结论 神经外科术后住院患者分离病原菌种类较多,主要以革兰阴性杆菌为主; 但与其他科室分离种类有差异,不同种类病原菌耐药性差异较大,临床医师应根据自身科室病原菌分离特点及药敏分析报告正确合理的使用抗生素; 并高度重视细菌耐药性的变化,规范操作,加强耐药菌的关注和用药情况,控制和减少院内感染的风险。
Abstract:
Objective To analyze the distribution and drugresistance of isolated pathogens in patients with neurological surgery in West China Hospital of Sichuan University,and provide evidence for clinical prevention and treatment.Methods Reviewed the clinical records and analyzed the data,and used WHONET 2018 software to analyze the distributionand drug susceptibility results of the isolated strains of the microbes collected by neurosurgery in 2014～2018.Results 4 209 strains ofclinical,pathogens were Gram-negative bacteria,accounting for 77.6%(3 266/4 209),Gram-positive bacteria accounting for 19.9%(837/4 209),and fungi accounting for 2.5%(106/4 209).The top five pathogens with the highest amount ofseparation were Klebsiella pneumoniae 21.4%(899/4 209).Acinetobacter baumannii 15.5%(651/4 209),Pseudomonas aeruginosa 12.2%(515/4 209),large intestine Escherichia coli 8.6%(361/4 209)and Staphylococcus aureus 6.7%(281/4 209).According to the type of specimen,sputum specimen was 60.6%(2 551/4 209),blood specimen 12.0%(505/4 209),urine Liquid specimens 10.6%(446/4 209),cerebrospinal fluid specimens 7.5%(316/4 209),secretion specimens 4.4%(187/4 209)and other types of specimens such as pleural and ascites,bile,alveolar lavage fluid,etc.4.8%(204/4 209).Separation rate of multi-drug resistant bacteria,MRSA separation rate decreased year by year,but other multi-drug resistant bacteria had increased to varying degrees,especially the carbapenem-resistant Klebsiella pneumoniae isolation rate increased significantly trend.Conclusion There were many types of pathogens in hospitalized patients after neurosurgery,mainly Gram-negative bacilli.However,there were differences in the types of isolation from other departments,and the resistance of different kinds of pathogens was quite different.Clinicians should distinguish the characteristics of pathogens in their own departments.Drug susceptibility analysis reports the correct and rational use of antibiotics,and attaches great importance to changes in bacterial resistance,standardize operations,strengthen the attention and medication of drug-resistant bacteria,and control and reduce the risk of nosocomial infections.

参考文献/References:

[1] 许红利.神经外科患者临床感染细菌分布和耐药性监测[J].临床合理用药杂志,2016,9(3B):102-103. XU Hongli.Monitoring of bacterial infection distribution and drug resistance in patients with neurosurgery[J].Chinese Journal of Clinical Rational Drug USA,2016,9(3B):102-103. [2] 张梅,刘娜,牟娜,等.神经外科住院患者院内感染病原菌分布特点及耐药性分析[J].现代预防医学,2015,42(14):2651-2653. ZHANG Mei,LIU Na,MU Na,et al.Analysis of the distribution characteristics and drug resistance of pathogenic bacteria for nosocomial infections in neurosurgicaly patients[J].Modern Preventive Medicine,2015,42(14):2651-2653. [3] SUN Wenjia,CHEN Hongbin,LIU Yudong,et al.Prevalence and characterization of heterogeneous vancomycin-intermediate Staphylococcus aureus isolatesfrom 14 cities in China[J].Antimicrob Agents Chemother,2009,53(9):3624-3649. [4] 马万红,韩世波.重型颅脑损伤并发肺部感染病原菌分布及预防措施[J].现代医药卫生,2014,30(7):1031-1032. MA Wanhong,HAN Shibo.Distribution and preventive measures of pathogenic bacteria in patients with severe craniocerebral injury complicated with pulmonary infection[J].Journal Modern Medicine and Health,2014,30(7):1031-1032. [5] 雷三喜.神经外科医院感染的高危因素及控制对策[J].中国社区医师,2016,32(4):53,55. LEI Sanxi.Analysis of high risk factors and control measures of nosocomial infection in department of neurosurgery[J].Chinese Community Doctors,2016,32(4):53,55. [6] DURANTE-MANGONI E,ZARRILLI R.Global sp-read of drug-resistant Acinetobacter baumannii:molecular epidemiology and management of antimicrobial resistance[J].Future Microbiol,2011,6(4):407-422. [7] 卢丽明,邱芳华.2012～2014年血流感染的病原菌分布及耐药性分析[J].国际检验医学杂志,2016,37(24):3385-3387,3390. LU Liming,QIU Fanghua.Distribution and drug resistance analysis ofpathogens from bloodstream infections during 2012～2014[J].International Journal of Laboratory Medicine,2016,37(24):3385-3387,3390. [8] 周静,陶丽.西安市第四医院2012～2014年多重耐药菌的临床分布分析[J].现代检验医学杂志,2016,31(2):127-129. ZHOU Jing,TAO Li.Analysis of clinical distribution of multi drug resistant from 2012 to 2014[J].Journal of Modern Laboratory Medicine,2016,31(2):127-129. [9] 胡付品,郭燕,朱德妹,等,2017年CHINET中国细菌耐药性监测[J].中国感染与化疗杂志,2018,18(3):241-251. HU Fupin,GUO Yan,ZHU Demei,et al.Antimicrobial resistance profile of clinical isolates in hospital across China:report from the CHINET survillance program,2017[J].Chinese Journal of Infection and Chemotherapy,2018,18(3):241-251. [10] 樊华,刘丽,左晶晶,等.呼吸病房产超广谱β-内酰胺酶肺炎克雷伯菌的耐药性及脉冲场电泳分析[J].实用医学杂志,2017,33(20):3462-3466. FAN Hua,LIU Li,ZUO Jingjing,et al.Antibiotic resistance and PFGE of genotyping of Klebsiella pneumoniae from neonatal ward infections[J].Journal of Practical Medicine,2017,33(20):3462-3466.

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备注/Memo

备注/Memo:
作者简介:邓 劲(1991-),男,医学学士,技师,研究方向:细菌耐药分析及耐药机制研究,E-mail:664256097@qq.com。2019-03-28 修回日期:2019-04-15
更新日期/Last Update: 2019-07-30