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目的了解医院外科感染常见病原菌的分布及其耐药性,为外科院内感染合理选用抗生素提供参考。方法收集医院外科2013年8月~2015年8月住院且发生感染的患者210例,分离培养并鉴定细菌,采用K-B纸片法进行药敏试验,对病原菌的来源、分布及耐药情况进行统计分析。结果210例患者中发生医院感染32例,感染率为15.23%;共检出病原菌65株,以革兰阴性菌为主,占58.46%(38/65),其中大肠埃希菌占27.69%,铜绿假单胞菌占9.23%,肺炎克雷伯菌占6.15%;检出革兰阳性菌23株,占35.38%,,其中金黄色葡萄球菌占16.92%,表皮葡萄球菌、肠球菌及溶血性链球菌分别占7.69%、6.15%和3.08%;大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌属产ESBLs株分别为10、3和2株,各占相应菌株的55.56%、50.00%和50.00%,未检出对亚胺培南耐药的产ESBLs株;检出MRSA7株,占金黄色葡萄球菌的45.45%,该菌对万古霉素和呋喃妥因的敏感率均为100.00%。检出真菌4株,占6.15%,以白色念珠菌为主。结论医院外科感染以革兰阴性菌为主,该类菌对亚胺培南敏感。医院外科感染及多重耐药情况严重,应作病原菌的分离及药敏试验,合理选用抗菌药物进行抗感染治疗。
Objective To understand the distribution and drug resistance of common pathogens in surgical surgeries in hospitals and provide a reference for rational use of antibiotics in surgical nosocomial infections. Methods Totally 210 patients were hospitalized and infected in the hospital from August 2013 to August 2015. Bacteria were isolated and identified. Drug susceptibility test was carried out by KB paper method. The origin, distribution and drug resistance of pathogens were statistically analyzed analysis. Results Among the 210 patients, 32 cases of nosocomial infection occurred and the infection rate was 15.23%. A total of 65 pathogenic bacteria were detected, accounting for 58.46% (38/65) of which were gram-negative bacteria, of which Escherichia coli accounted for 27.69% Pseudomonas aeruginosa accounted for 9.23%, Klebsiella pneumoniae accounted for 6.15%; 23 Gram-positive bacteria were detected, accounting for 35.38%, of which Staphylococcus aureus accounted for 16.92%, Staphylococcus epidermidis, enterococci and hemolytic Streptococcus accounted for 7.69%, 6.15% and 3.08% respectively. Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae ESBLs producing strains were 10, 3 and 2 strains, accounting for 55.56% of the corresponding strains, 50.00% and 50.00%. No ESBLs-producing strains resistant to imipenem were detected. Strain MRSA7 was detected, accounting for 45.45% of that of Staphylococcus aureus. The sensitivity of the strain to vancomycin and nitrofurantoin were both 100.00% . Four fungi were detected, accounting for 6.15%, mainly Candida albicans. Conclusions Surgical infection in hospitals is mainly Gram-negative bacteria, which are sensitive to imipenem. Surgical infection in hospitals and multi-drug resistance is serious, should be the separation of pathogenic bacteria and drug susceptibility testing, the rational use of anti-bacterial drugs for anti-infective treatment.