《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (04): 460-463.

• 临床研究 • 上一篇    下一篇

395例脊髓损伤患者医院感染的病原菌分布和耐药情况分析

赵国伟，高钧
   

  1. 中国康复研究中心北京博爱医院药剂科，北京市 100068。
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-04-25 发布日期:2015-04-25

Distribution and Drug- resistance of Pathogens of Nosocomial Infection in Spinal Cord Injury: 395 Cases Report

ZHAO Guo-wei, GAO Jun
   

  1. The Department of Pharmacology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-04-25 Online:2015-04-25

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被引次数

9

摘要： 目的 分析脊髓损伤患者医院感染的部位、菌株构成和耐药情况，为临床治疗和抗生素的合理应用提供科学依据。方法 选取 2012 年 6 月~2013 年 12 月本院收治的 395 例脊髓损伤患者为研究对象，对感染部位细菌学和耐药情况进行分析。结果132例脊髓损伤患者发生医院感染。主要部位为泌尿道(71.1%)和下呼吸道(24.2%)。主要致病菌是大肠埃希菌(45.6%)、铜绿假单胞菌(18.1%)、肺炎克雷伯杆菌(11.4%)和奇异变形杆菌(8.7%)；致病菌对第二、三代头孢类抗生素和喹诺酮类呈中高度耐药，而对含β-内酰胺酶抑制剂的复方制剂和氨基糖苷类较敏感。结论 脊髓损伤患者医院感染的部位多为泌尿道和呼吸道，致病菌以革兰阴性杆菌为主。致病菌有较强的耐药性，临床应根据细菌培养和药敏实验结果，合理选择抗生素，并根据 PK/PD(药动学/药效学)理论优化抗菌药物治疗方案。

关键词: 脊髓损伤, 医院感染, 病原菌, 抗菌治疗

Abstract: Objective To pave the way for clinical therapy and reasonable administration of antibiotics, and to analyze the kinds and drug-resistance of pathogens of nosocomial infection in patients with spinal cord injury. Methods Bacteriology of infection and drug resistance were analyzed in 395 patients with spinal cord injury in the hospital from Jun., 2012 to Dec., 2013. Results There were 132 cases with nosocomial infection. Most of the infections were found in urinary tract (71.1%) and lower respiratory tract (24.2%). The main pathogenic germs were Escherichia coli (45.6%), P. Aeruginosa (18.1%), K. pneumonia (11.4%) and P. mirabilis(8.7%), which were resistant to the second or third generation cephalosporins and quinolones moderately or severely, but sensitive to β-lactamase inhibitor combinations and aminoglycosides. Conclusion The main pathogenic bacteria in nosocomial infection of patients with spinal cord injury are G- bacilli. The bacteria are resistant moderately or severely to antibiotics, which should be selected rationally by bacterial culture and drug susceptibility test, and optimized rationally with PK/PD (pharmacokinetics and pharmacodynamics).

Key words: spinal cord injury, nosocomial infection, pathogens, antibiotic therapy