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目的调查和分析神经内科患者合并下呼吸道感染的病原菌谱和耐药性,为预防医院感染和指导抗菌药物的合理使用提供依据。方法回顾性分析2013年-2015年并发下呼吸道感染的神经内科住院患者中分离的病原菌谱及其耐药性。结果共收集332份痰液,检出550株病原菌;革兰阴性菌364株(66.2%),以肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌为主;革兰阳性菌31株(5.6%),以金黄色葡萄球菌为主;真菌155株(28.2%),以白色念珠菌为主;肺炎克雷伯菌对除氨苄西林外的抗菌药物敏感性均较高;鲍曼不动杆菌和铜绿假单胞菌对大部分抗菌药物耐药性较高;大肠埃希菌对部分抗生素保持敏感;金黄色葡萄球菌对利奈唑胺、万古霉素敏感;未发现耐药真菌。结论神经内科住院患者下呼吸道感染病原菌以革兰阴性菌最常见,监测感染的病原菌谱及耐药性,对医院感染的防治非常重要。
Objective To investigate and analyze the pathogenic bacteria spectrum and drug resistance of lower respiratory tract infection in patients with neurological diseases and provide basis for preventing nosocomial infection and guiding the rational use of antibacterials. Methods A retrospective analysis of the pathogenic bacteria spectrum and drug resistance in hospitalized patients with neurology of lower respiratory tract infection complicated with lower respiratory tract infection between 2013 and 2015 was conducted. Results A total of 332 sputum samples were collected and 550 pathogens were detected. 364 strains (66.2%) of Gram-negative bacteria were identified as Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli ; Gram-positive bacteria 31 (5.6%), mainly Staphylococcus aureus; 155 fungi (28.2%), mainly Candida albicans; Klebsiella pneumoniae in addition to ampicillin outside the antibacterial drug sensitivity Were higher; Acinetobacter baumannii and Pseudomonas aeruginosa higher resistance to most antibiotics; Escherichia coli is sensitive to some antibiotics; Staphylococcus aureus sensitive to linezolid, vancomycin; No resistant fungi found. Conclusions Gram-negative bacteria are the most common pathogenic bacteria in lower respiratory tract inpatients in neurology department. It is very important to monitor pathogenic bacteria spectrum and drug resistance in hospital infection and prevent and cure nosocomial infections.