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目的了解住院患者不同部位穿刺液和血液标本分离病原菌种类及其耐药特点,为制定医院感染控制策略提供依据。方法采用细菌分离鉴定技术和药敏试验方法,对某医院住院患者各类穿刺液标本进行检测与分析。结果从该医院住院患者送检的骨髓、脑脊液、胸腹水和血液标本中共分离病原菌864株,其中肠杆菌科细菌、非发酵菌和革兰阳性球菌构成比分别为46.06%、8.80%和44.09%。优势菌居前3位的分别是大肠埃希菌、肺炎克雷伯菌和表皮葡萄球菌,构成比依次为25.93%、9.61%和8.49%。所分离的鲍曼不动杆菌耐药严重,仅对碳青霉烯类药物敏感;革兰阳性球菌对利奈唑胺、万古霉素和替考拉宁敏感。结论大肠埃希菌、肺炎克雷伯菌和表皮葡萄球菌为主要优势菌,革兰阴性杆菌严重耐药。
Objective To understand the types and drug resistance of pathogenic bacteria isolated from puncture fluid and blood in different parts of inpatients and to provide basis for the development of nosocomial infection control strategies. Methods Bacterial isolation and identification techniques and susceptibility testing methods were used to detect and analyze various types of puncture fluid in hospital patients. Results 864 strains of pathogens were isolated from bone marrow, cerebrospinal fluid, pleural, ascitic fluid and blood samples from inpatients in this hospital. The constituent ratios of Enterobacteriaceae, non-fermentative bacteria and Gram-positive cocci were 46.06%, 8.80% and 44.09% . Among the top three predominant bacteria, Escherichia coli, Klebsiella pneumoniae and Staphylococcus epidermidis were the most common, with the proportions of 25.93%, 9.61% and 8.49%, respectively. The Acinetobacter baumannii isolated was highly resistant and susceptible only to carbapenems; gram-positive cocci were sensitive to linezolid, vancomycin and teicoplanin. Conclusion Escherichia coli, Klebsiella pneumoniae and Staphylococcus epidermidis are dominant bacteria, Gram-negative bacilli are highly resistant.