神经外科下呼吸道感染患者痰标本分离病原菌特点与耐药性分析.doc

神经外科下呼吸道感染患者痰标本分离病原菌的特点及耐药性分析 韩娟，丁进亚，徐娟，徐鸣皋，孙洁，刘维新 （广州军区武汉总医院检验科，武汉 430070） 【摘要】 目的 了解神经外科下呼吸道感染患者痰标本分离病原菌的特点及耐药性，为院内感染的预防和治疗提供依据。方法 对2012年4月~2013年3月神经外科下呼吸道感染患者中分离出一种以上病原菌的患者（228例），采用VITEK 2 compact细菌鉴定仪进行分离菌株的鉴定和药敏试验。结果 神经外科下呼吸道多种病原菌合并感染占10.9%，其中革兰阳性球菌（Gram positive cocci G+c）与G+c合并感染2例（0.9%）；G+c与革兰阴性杆菌（Gram negative bacilli G-b）合并感染89例（39.0%）；G-b与G-b合并感染133例（58.3 %）；一种细菌合并真菌感染4例（1.8%）。G+c主要以金黄色葡萄球菌（Staphylococcus aureus，SA）为主，检出84株（36.8%），其中耐甲氧西林金黄色葡萄球菌（MRSA）检出44株（19.3%）。G-b以铜绿假单胞菌（Pseudomonas aeruginosa,PAE），肺炎克雷伯氏菌（Klebsiella pneumoniae，Kp），鲍曼不动杆菌（Acinetobacter baumannii,AB），大肠埃希菌（Escherichia coli,E. coli）为主。结论 神经外科下呼吸道合并感染多为两种病原菌，主要致病菌多为多重耐药（multidrug-resistant, MDR）菌株。 【关键词】 下呼吸道; 感染; 病原菌; 耐药性 An Analysis of Bacterial Distribution Characteristics of Lower Respiratory Infections and Drug Resistance Results in Neurosurgery Department HAN juan ,DING jin-ya, XU juan,XU ming-gao,SUN jie,LIUO wei-xin（Department of Laboratory Medicine,Wuhan General Hospital of Guangzhou Command, Wuhan 430070,China） 【Abstract】Objectives To investigate the bacterial distribution characteristics of lower respiratory infections and pathogenic bacteria resistance to drugs in the neurosurgery department, providing a basis for prevention and treatment of nosocomial infection. Methods From April 2012 to March 2013, more than one pathogens were isolated form sputum in patients（about 228）with lower respiratory tract infections of neurosurgery department, and VITEK 2 compact system was applied for bacteria identification and antimicrobial susceptibility testing. Results The bacteria mixed infections rate of lower respiratory tract in neurosurgery was 10.9%.Among all isolated strains, the G+c and G+c mixed infections were 2 strains（0.9%）; G+c and G-b mixed infections were 89 strains（39.0%）; G-b and G-b mixed infections were 133 strains（58.3%）;one bacteria and fungal mixed infections were 4 strains（1.8%）.Staphylococcus aureus was the most prominent in the isolated in G+c,