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[摘要]
目的 探讨2013—2017年中山市陈星海医院妇科病原菌的分布及其耐药性,旨在为临床预防及诊治提供相应的经验。方法 收集2013—2017年中山市陈星海医院妇科病房收治的发生住院感染的562例患者的临床资料,对其感染病原菌的分布及耐药性进行分析。结果 共分离出病原菌1 048株,标本来源以宫颈分泌物为主,占52.86%。感染部位主要发生在宫颈和腹部切口,构成比分别为26.81%、25.00%。革兰阴性菌615株,构成比为58.68%,主要为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、沙雷菌属和鲍曼不动杆菌;革兰阳性菌288株,构成比为27.48%,主要为金黄色葡萄球菌和表皮葡萄球菌;真菌145株,构成比为13.84%,主要为白色假丝酵母和热带假丝酵母菌。革兰阳性菌中表皮葡萄球菌对头孢曲松、庆大霉素和头孢哌酮舒巴坦的耐药性较高,耐药率均在80%以上。金黄色葡萄球菌对亚胺培南和阿奇霉素的敏感率较高。革兰阴性菌中大肠埃希菌和铜绿假单胞菌对阿米卡星和亚胺培南具有较高的耐药性,耐药率均高达85%以上;肺炎克雷伯菌对庆大霉素、亚胺培南和阿奇霉素的耐药率均为0。结论 2013—2017年中山市陈星海医院妇科病原菌分布较为广泛,在临床中应结合药物的耐药性合理使用抗菌药物。
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[Abstract]
Objective To explore the distribution and drug resistance of gynecological pathogens in Chenxinghai Hospital of Zhongshan City from 2013 to 2017, and to provide corresponding experience for clinical prevention and treatment. Methods The clinical data of patients (562 cases) with hospital infection in the gynecological ward of Chenxinghai Hospital of Zhongshan City from 2013 to 2017 were enrolled. The pathogen distribution and drug resistance were analyzed. Results There were 1 048 strains of pathogens identified. The specimens were mainly from cervical secretions, accounting for 52.86%. The most infection sites were cervical and abdominal incisions, accounting for 26.81% and 25.00%, respectively. There were 615 strains of Gram-negative bacteria (58.68%), mainly Escherichia coli, Pseudomonas aeruginosa, Serratia, and Acinetobacter baumannii. There were 288 strains of Gram-positive bacteria (27.48%), mainly Staphylococcus aureus and Staphylococcus epidermidis. There were 145 strains of Fungi (13.84%), mainly Candida albicans and Candida tropicalis. S. epidermidis had high drug resistance against ceftriaxone, gentamicin, and cefoperazone and sulbactam, and the drug resistance rate was more than 80%. The sensitive rate of S. aureus against imipenam and azithromycin were high. E. coli and P. aeruginosa had high drug resistance against amikacin and imipenam, and the drug resistance rate was more than 85%. The drug resistance rate of P. aeruginosa against gentamicin, imipenam, and azithromycin were 0. Conclusion The distribution of pathogenic bacteria in gynecological wards of Chenxinghai Hospital of Zhongshan City from 2013 to 2017 was relatively extensive. Antibiotics should be used rationally in combination with drug resistance in clinical practice.
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