静脉插管相关感染的病原学分析

目的调查静脉插管相关感染的病原微生物分布及其体外药敏试验的情况，为临床诊疗提供依据。方法回顾性分析我院2006年1月至2007年12月期间实施静脉插管的患者发生感染的情况，同时对分离的病原微生物及其耐药性进行分析。结果106例阳性标本中革兰阳性球菌53株（50％），革兰阴性杆菌33株（31．1％），真菌16株（15．1％）；革兰阳性球菌中以凝固酶阴性葡萄球菌（31．1％）、金黄色葡萄球菌（11．3％）为主，在葡萄球菌感染中耐苯唑西林金黄色葡萄球菌（MRSA）占75％，耐苯唑西林凝固酶阴性葡萄球菌（MRSCON）占87．9％；革兰阴性杆菌中以鲍曼不动杆菌（9．4％）、铜绿假单胞菌（6．6％）为主；真菌以白色念珠菌（4．7％）及热带念珠菌（3．8％）为主。革兰阳性球菌对万古霉素、利奈唑胺及替考拉宁敏感性高；革兰阴性杆菌较敏感的药物为头孢哌酮／舒巴坦、美罗培南、亚胺培南及阿米卡星，耐药率分别为5％、9．1％、14．8％及15．4％。结论静脉插管相关感染病原微生物以凝固酶阴性葡萄球菌多见，细菌耐药比较严重，应重视抗生素的合理使用。

Analysis of the pathogenic micra-organisms in venous catheter related infectiens

Objective To investigate the distribution and antimierobial susceptibility testing of the pathogenic micro-organisms of venous catheter related infections. Methods All of the 106 samples＇ laboratory data from 2006 to 2007 with venous catheter related infections in The First Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. Results Total of 106 strains were isolated from all venous catheter specimens, of which 53 strains （50%） were Grampositive cocci,33 strains （31.1%） were gram-negative bacilli,and 16 strains （15.1%） were fungi. The most cummon pathogens in Gram-positive cocci were coagulase negative Staphylococci（CNS） （31. 1%） and Staphylococcus aureus （ 11.3% ） Methicillin-resistant staphylococcus aureus （MRSA） accounted for 75% and methicillin-resistant coagulase negative staphylococci （MRCNS） accounted for 87.9 % in cocci infection. Acinetobacter baumannii was 9.4% and Pseudomonas aeruginosa was 6.6% in gram-negative bacilli ; Candida albicans was 4.7% and Candida tropicalis was 3.8% in fungi. Gram-positive cocci were very sensitive to Vancomycin, Linezolid and Teicoplanin. Gram-negative bacilli were more sensitive to Cefoperazon/Sulbactam, Meropenem,Imipenem and amikacin than to other drugs and the resistance rate was 5% ,9.1%, 14.8% and 15.4% respectively. Conclusions The most common pathogens in venous catheter related infections were coagulase negative Staphylococci（CNS） and all isolated becteria showed a serious resistance to most antibiotics. Properly use of antibiotics is very necessary.