166例肾移植患者术后医院感染病原菌的分布及耐药性分析

Distribution and drug resistance of 166 pathogenic bacteria of postoperative infections in renal transplantation patients

摘要:

了解肾移植患者术后医院感染病原菌的分布、标本来源及耐药性，为预防和合理使用抗菌药物有效控制肾移植术后患者医院感染提供依据。方法回顾分析郑州人民医院2013 年1 月-2015 年12 月肾移植患者术后送检的各类标本中分离出的病原菌的分布、标本来源及耐药性，细菌的鉴定和药物敏感性试验采用法国生物梅里埃公司VITEK 2 Compact 全自动细菌鉴定药敏分析仪。结果共分离出204 株病原菌，其中，革兰阴性菌144 株，革兰阳性菌48 株，真菌12 株，分别占70.588%、23.529%和5.882%；主要来源于中段尿，其次是痰液和伤口分泌物，依次占39.216%、27.451%和13.725%；主要革兰阴性菌对多数常用抗菌药物产生了高度耐药，主要革兰阳性菌金黄色葡萄球菌的耐药率更高，MRSA 阳性率高达58.333%，未发现耐万古霉素和利奈唑胺的金黄色葡萄球菌和屎肠球菌。结论肾移植患者术后医院感染的发生率较高，泌尿系统和呼吸系统是其主要易感部位，革兰阴性菌是主要病原菌，且对多数抗菌药物呈现高度耐药，所以要加强细菌监测和药物敏感性试验，有效预防和控制医院感染的发生。

Abstract:

To explore the distribution and drug resistance of pathogenic bacteria causing infections inthe patients after renal transplantation so as to provide basis for rational use of antibiotics. Methods Pathogenic bacteria were isolated from the clinical specimens obtained from the patients who underwent renal transplantation in the hospital from January 2013 to December 2015, and identified by the VITEK 2 Compact system. Results Totally 204 strains of bacteria were isolated consisting of 144 strains of Gram-negative bacteria (70.588%), 48 strains of Gram-positive bacteria (23.529%) and 12 strains of fungi (5.882%), which were derived from urine (39.216%), sputum (27.451%) and wound secretions (13.725%). The majority of Gram-negative bacteria were highly resistant to commonly used antibiotics. (SA) showed a even higher drug-resistance rate. The positive rate of multiresistant SA was as high as 58.333%. But SA and resistant to Vancomycin and Linezolid were not verified. Conclusions There are high incidences of urinary and respiratory infections in patients with renal transplantation. The main pathogens are Gram-negative bacteria which are highly resistant to commonly used antibiotics. We should strengthen the surveillance of pathogenic bacteria and interventions so as to control hospital infections.