作　　者： (侯钧）; (罗媛）; (张婧）; (马瑜珊）; (李扬）; (康月茜）; (张任飞）;

机构地区： 绵阳市第三人民医院,四川绵阳621000

出　　处： 《四川精神卫生》 2017年第4期352-355,共4页

摘　　要： 目的分析精神科患者院内感染的病原菌分布及细菌耐药情况,为临床合理用药提供参考。方法采用回顾性分析方法,收集2015年在四川省精神卫生中心精神科经病原学检查被确诊为院内细菌感染患者174例,对其送检标本进行细菌分离培养,使用VITEK-2 Compact微生物分析系统进行菌株鉴定,采用K-B法进行体外药敏试验,应用WHONET 5.6软件分析药敏结果。结果共分离出病原菌181株,病原菌的标本类型以尿液为主(45.86%),感染部位以泌尿系统为主,排名前3位的病原菌依次为大肠埃希菌(27.07%)、金黄色葡萄球菌(12.15%)和肺炎克雷伯菌(9.39%)。大肠埃希菌对哌拉西林、头孢唑啉、复方新诺明、替卡西林/克拉维酸的敏感性均低于50%,对哌拉西林/他唑巴坦、头孢西丁、磷霉素、呋喃妥因的敏感性均高于90%,尚未发现对阿米卡星及碳青霉烯类耐药的大肠埃希菌菌株。结论精神科患者院内感染发生部位以泌尿系统为主,常见病原菌为大肠埃希菌,金黄色葡萄球菌和肺炎克雷伯菌,大肠埃希菌的耐药性较严重。 Objective To analyze the distribution of pathogens and bacterial resistance in psychiatric patients with nosocomial infection, and provide scientific evidences for clinical rational use of antibiotics. Methods With retrospective analysis methods, a total of 174 nosocomial infected patients confirmed by etiological examination were collected from Psychiatry Department in Sichuan Mental Health Center during 2015. The specimens collected from inpatients were isolated cultured, strains identification were performed by using the VITEK -2 compact microbiological analysis system, K - B methods were used for antimicrobial susceptibility testing in vitro, and WHONET 5. 6 software was used to analyze the results of drug sensitivity test. Results A total of 181 strains of pathogenic bacterium were isolated, and the pathogenic bacterium were mainly separated from urine samples（45. 86% ） , and the site of infection was mainly urinary system. The top 3 pathogens were Escherichia coli （27. 07% ）,Staphylococcus aureus（ 12. 15% ） and Klebsiella pneumoniae（9. 39% ）. The sensitivity of Escherichia coli to piperacillin, cefazolin, sulfamethoxazole, piperacillin/clavulanic acid were all lower than 50% , and the sensitivity to piperacillin / tazobactam, cefoxitin, fosfomycin, nitrofurantoin were all higher than 90%,no Escherichia coli strains were found to be resistant to carbapenems or amikacin. Conclusion The main nosocomial infections in psychiatric patients were occurred in urinary system. Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae were the common pathogenic bacteria, and the antibiotic resistance of Escherichia coli was more serious than others.

关 键 词： 精神科 病原菌 耐药性