【摘要】 目的分析医院经体外循环术后发生感染的病原菌分布及耐药性,为医院抗菌药物的选用提供帮助。方法回顾性分析2009年1月-2011年12月83例经体外循环术后发生感染的患者资料。结果 83例发生感染患者共检出病原菌92株,9例患者存在多重感染,感染的部位主要为呼吸道、泌尿道、血液及皮肤;检出感染病原菌革兰阳性球菌占42.39%,革兰阴性杆菌占51.09%,真菌占6.52%;表皮葡萄球菌及金黄色葡萄球菌对青霉素G、苯唑西林、氨苄西林耐药率高达100.00%,对呋喃妥因及万古霉素耐药率低0～5.26%;不动杆菌属、肺炎克雷伯菌、大肠埃希菌对头孢他啶、头孢吡肟耐药率均>50.00%,真菌对酮康唑、伊曲康唑、两性霉素B耐药率均>50.00%,对咪康唑及氟康唑耐药率为0。结论经体外循环心脏手术患者术后感染主要以呼吸道、泌尿道感染为主,病原菌对临床常用抗菌药物耐药率较高,术后应根据药物敏感试验合理选择抗菌药物。更多还原

【Abstract】 OBJECTIVE To analyze the distribution and drug resistance of the pathogenic bacteria causing infections after extracorporeal circulation so as to guide the reasonable use of antibiotics.METHODS The clinical data of 83 patients undergoing extracorporeal circulation from Jan 2009 to Dec 2011 were analyzed retrospectively.RESULTS A total of 92 strains of pathogens were isolated from 83 patients with the infections,nine of which were with multiple infections.The respiratory tract,urinary tract,blood,and skin were the main infection sites.42.39% of the isolated pathogens were the gram-positive cocci,51.09% were gram-negative bacilli,and 6.52% were the fungi.The drug resistance rates of S.epidermidis and Staphylococcus aureus to penicillin G,oxacillin,and ampicillin were as high as 100.00%,the drug resistance rates to nitrofurantoin and cancomycillin varied from 0 to 5.26%;the drug resistance rates of Acinetobacter,Klebsiella pneumoniae and Escherichia coli to ceftazidime,cefepime were higher than 50.00%;the drug resistance rates of the fungi to ketoconazole,itraconazole,and amphotericin B were over 50.00%,and the drug resistance rates to miconazole and fluconazole were 0.CONCLUSION The infections mainly occur in the respiratory tract and urinary tract of the patients after extracorporeal circulation.The pathogens are highly resistant to the commonly used antibiotics,thus it is necessary to use antibiotics reasonably on the basis of the drug susceptibility testing.更多还原