154例深静脉置管相关院内感染分析.docVIP

154例深静脉置管相关院内感染分析 　　[摘要] 目的 分析临床深静脉导管（DVC）培养的病原学特征和耐药性。方法 回顾性分析瑞金医院2010年全年送检的深静脉导管的病原学及其耐药性。结果 991份送检导管病原学阳性154例（15.54%），检出病原菌176株，其中G+菌、G-菌和真菌各占41.47%、36.36%和22.17%；五种常见病原菌分别是表皮葡萄球菌（20.45%）、鲍曼不动杆菌（15.34%）、金黄色葡萄球菌（11.93%）、白色假丝酵母菌（11.36%）和铜绿假单胞菌（6.25%）。金黄色葡萄球菌中MRSA占94.12%，凝固酶阴性葡萄球菌中MRScn占69.44%；鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌普遍存在多重耐药现象，鲍曼不动杆菌（26.92%）和铜绿假单胞菌（9.09%）甚至出现全耐药。结论 深静脉导管感染为院内感染，检出的病原菌多为耐药菌，无菌置管、加强导管的护理和加强病原学监测是控制DVC感染的关键。 　　[关键词] 医院感染；深静脉导管；病原学；耐药性 　　[中图分类号] R472.9 [文献标识码] B [文章编号] 1673-9701（2011）23-113-02 　　 　　Descriptive Analysis on the Cases of 154 Deep Venous Cathgeter Tip Related Nosocomial Infection 　　ZHENG Ailan1 CHEN Junfeng2 HAN Lizhong3 　　1. Laboratory Department，Hui’an County Hospital of Quanzhou，Hui’an 362100，China； 2.B Type Ultrasonography Room，Hui’an County Hospital of Quanzhou，Hui’an 362100，China；3.Department of Microbiology，Ruijin Hospital Affiliated to Medical School of Communication University of Shanghai，Shanghai 210075，China 　　 　　[Abstract] Objective To investigate the characteristics of the organisims of deep-venous catheter（DVC） tip culture and their antibiotics resistance. Menthods The culture results All 991 DVC tip were analyzed retrospectivly from January to December of 2010. Rusults Among 991 cather tip cultures,154（15.54%） were positive with 176 microorganisms： G+bacteria accounted for 41.47%,G-bacteria 36.36%,and yeasts22.17%.The fivemost common microorganisms were Staphylcoccus epidemidis（20.45%）, Acinetobacter baumanii（15.34%）, Staphylococcus aureus（11.93%）,Candida albicans（11.36%） and Pseudomonas aeruginosa（6.25%）. 94.12% of Staphylcoccus aureus were MRSA, 69.44% of Staphylcoccus epidemidis were MRScn.Kelbsiella pneumoniae，Pseudomonas areuginosa and Acinetobacter baumanni had an increasing tendency in drug-resistance and some of them were multiple drug-resistant. Conclusion The most common pathogens cultured from the DVC tip were drug-resistance.It’s key to regulation procedures of catheter placed and enforce medical attendance