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1、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VITEK2compact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(GrampositivecocciG+c)与G+c合并感染2例(0.9%);G+c与革兰阴性杆菌(Gram
2、negativebacilliG-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(Staphylococcusaureus,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(Pseudomonasaeruginosa,PAE),肺炎克雷伯氏菌(Klebsiellapneumoniae,Kp),鲍曼不动杆菌(Acinetobacterbaumannii,AB),大肠埃希菌(Escherichiacoli,E.coli)为
3、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AnAnalysisofBacterialDistributionCharacteristicsofLowerRespiratoryInfectionsandDrugResistanceResultsinNeurosurgeryDepartmentHANjuan,DINGjin-ya,XUjuan,XUming-gao,SUNjie,LIUOwei-xin(DepartmentofLaboratoryMedicine,Wuha
4、nGeneralHospitalofGuangzhouCommand,Wuhan430070,China)【Abstract】ObjectivesToinvestigatethebacterialdistributioncharacteristicsoflowerrespiratoryinfectionsandpathogenicbacteriaresistancetodrugsintheneurosurgerydepartment,providingabasisforpreventionandtreatmentofnosocomialinfection.MethodsFromApril2
5、012toMarch2013,morethanonepathogenswereisolatedformsputuminpatients(about228)withlowerrespiratorytractinfectionsofneurosurgerydepartment,andVITEK2compactsystemwasappliedforbacteriaidentificationandantimicrobialsusceptibilitytesting.ResultsThebacteriamixedinfectionsrateoflowerrespiratorytractinneur
6、osurgerywas10.9%.Amongallisolatedstrains,theG+candG+cmixedinfectionswere2strains(0.9%);G+candG-bmixedinfectionswere89strains(39.0%);G-bandG-bmixedinfectionswere133strains(58.3%);onebacteriaandfungalmixedinfectionswere4strains(1.8%).StaphylococcusaureuswasthemostprominentintheisolatedinG+c,about84s
7、trains(36.8%),methicillin-resistantstaphylococcusaureusaccountedfor44strainsoftheisolatedS.aureus.Pseudomonasaeruginosa,Klebsiellapneumoniae,AcinetobacterbaumanniiandEscherichiacoliwasthemostprominentintheisolate