内科重症监护病房致病菌的菌群变迁及耐药性分析──附513株检测报告  

Variation and resistance of pathogenic bacteria isolated from patients in medical intensive care unit

作　　者：黄汉[1] 廖康[1] 王海英[2] 罗兰[3] 曾燕[1] 

机构地区：[1]中山大学附属第一医院检验医学部,510080 [2]中山大学附属第一医院外科,510080 [3]中山大学附属第一医院中心实验室,510080

出　　处：《新医学》2005年第11期636-638,共3页Journal of New Medicine

摘　　要：目的:了解内科ICU致病菌的菌群变迁及其耐药情况。方法:对2001年1月～2004年12月从内科ICU送检标本检测出的致病菌及其耐药性资料进行回顾性研究分析。结果与结论:内科ICU的致病菌以革兰阴性杆菌为主,占54.2%;革兰阳性球菌占45.8%。占前5位的致病菌分别为铜绿假单胞菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌。检出标本的类型以痰和支气管吸出物为主,占83.2%(427/513),其余依次为血液、脓性分泌物、静脉插管尖端等。其中,2001～2003年均以金黄色葡萄球菌占首位,铜绿假单胞菌居其次,2004年则刚好相反。2001～2004年间的药物敏感试验显示,致病菌对多种抗菌药均有较高的耐药性,仅革兰阴性杆菌对头孢哌酮钠舒巴坦的耐药率最低(小于17%),革兰阳性球菌对去甲万古霉素、替考拉宁未见耐药株。2001～2004年的连续观察显示,内科ICU致病菌的耐药率高。加强监测ICU的菌群及其耐药性,对提高抗感染治疗的效果、减少耐药菌株有重要作用。Objective： To investigate the variation and resistance of pathogenic bacteria isolated from patients in medical intensive care unit. Methods： The identified pathogenic bacteria and their drug resistance, collected from patients in medical intensive care unit from January 2001 to December 2004, were analyzed retrospectively. Results and conclusion： Majority （54.2%） of pathogenic bacteria were Gram-negative bacilli. Gram-positive cocci accounted for 45.8% . The first five pathogenic bacteria were P. aeruginosa, S. aureus, S. coagulase-negative, A. baumanii and S. maltophilia respectively. The most common samples （427/513, 83.2% ） from which pathogenic bacteria could be identified were sputum and aspirate from respiratory tracts. Others were blood, sup- purative secretion and samples from the tips of invasive catheters. The first and second pathogenic bacteria were S. aureus and P. aeruginosa during 2001 - 2003, but was the opposite in 2004. Drug sensitivity tests showed that most of the pathogenic bacteria were multi-drug resistance. The lowest resistance to cefoperazone sodium-sulbactam occurred in Gram-negative bacilli＇ （ 〈 17% ）, while the sensitivity of Gram-positive cocci to norvancomycin and teicoplanin was up to 100%. High resistance occurred in pathogenic bacteria isolated from patients in medical intensive care unit. Intensive monitoring of the variation and drug resistance of pathogenic bacteria is important in improving the therapeutic efficacyand reducing resistance.

关 键 词：重症监护病房 感染 致病菌 耐药性 耐药性分析 菌群变迁 致病菌 内科 检测报告 金黄色葡萄球茵 

分 类 号：R446.5[医药卫生—诊断学]