尿毒症住院患者感染部位与病原菌分析

发布时间：2018-04-28 06:10

本文选题：尿毒症 + 院内感染　；参考：《中华医院感染学杂志》2017年05期

【摘要】：目的探讨尿毒症住院患者感染部位与病原菌分布,为预防和控制患者感染提供依据。方法选取2015年8月-2016年8月于医院血液净化科住院治疗,确诊为慢性肾功能不全尿毒症期并发感染的患者154例为研究对象,统计感染部位构成比,病原菌分布和药敏结果,采用SPSS22.0对数据进行分析。结果下呼吸道感染患者最多,占57.14%;分离出病原菌179株,其中,革兰阴性菌占43.01%,革兰阳性菌占45.81%,真菌占11.18%;革兰阴性菌和革兰阳性菌在不同部位的占比不同,下呼吸道两类细菌占比相似,腹膜和导管以革兰阳性菌为主,分别占62.07%和75.00%,泌尿系革兰阴性菌占70.83%;耐药性分析中,革兰阳性菌耐药率较高,溶血葡萄球菌对青霉素、亚胺培南、美罗培南、哌拉西林耐药率为100%,革兰阳性菌对替考拉宁、万古霉素、美满霉素、利奈唑胺耐药率低于10%;革兰阴性菌对哌拉西林、阿米卡星、美满霉素耐药率低于20%,大肠埃希菌对环丙沙星、左氧氟沙星、庆大霉素、磺胺甲VA唑/甲氧苄啶、四环素耐药率50%;真菌耐药率均低于15%。结论尿毒症患者感染发生部位广泛,病原菌多为院内常见致病菌,耐药性高,应根据药敏结果合理应用抗菌药物。
[Abstract]:Objective to investigate the distribution of infection sites and pathogens in hospitalized patients with uremia, and to provide a basis for preventing and controlling the infection of patients. Methods 154 patients with chronic renal failure and infection during the period of August 2015 -2016 August were treated in the hospital blood purification department. The results of bacterial distribution and drug sensitivity were analyzed with SPSS22.0. The results showed that the most of the lower respiratory tract infection was 57.14%, and 179 strains were isolated. Among them, Gram-negative bacteria accounted for 43.01%, Gram-positive bacteria accounted for 45.81%, fungi accounted for 11.18%, Gram-negative bacteria and Gram-positive bacteria were different in different parts, and two types of lower respiratory tract were accounted for. The peritoneum and catheters were mainly Gram-positive bacteria, which accounted for 62.07% and 75%, respectively, and 70.83% of the Gram-negative bacteria in the urinary system. The resistance rate of Gram-positive bacteria was higher in the drug resistance analysis. The resistance rate of Staphylococcus hemolytic Staphylococcus to penicillin, imipenem, meropenem and piperacillin was 100%, and Gram-positive bacteria were treated with teicoplanin, vancomycin, and mildew. The resistance rate of linezolid was lower than 10%, and the resistance rate of Gram-negative bacteria to piperacillin, Amikacin and mycophencin was lower than 20%, and Escherichia coli was 50% of ciprofloxacin, levofloxacin, gentamicin, sulfamethoxazole / trimethoprim, tetracycline 50%, and the rate of fungal resistance was lower than that of 15%. conclusion that the infection site of uremia patients was widespread. The original bacteria are mostly pathogenic bacteria in the hospital, and the drug resistance is high. Antibiotics should be rationally applied according to the results of drug sensitivity.

【作者单位】：天津医科大学第二医院血液净化科;
【分类号】：R692.5

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