重症监护病房与呼吸内科下呼吸道感染病原谱分布及耐药性分析  

The distribution and drug resistance of pathogenic bacteria at lower respiratory tract infection in intensive care unit and respiration department

作　　者：余素飞[1] 李婷婷 沈定树[1] 陈慧红[1] 李丹萍[1] 

机构地区：[1]浙江省台州医院检验科,浙江临海317000 [2]临海市第一人民医院,浙江临海317000

出　　处：《中国微生态学杂志》2007年第1期75-77,共3页Chinese Journal of Microecology

摘　　要：目的通过对比台州医院重症监护病房(ICU)与呼吸内科下呼吸道革兰阴性菌的分离情况及其主要分离菌——铜绿假单胞菌的耐药性,为临床合理防治提供依据。方法用WHONET5软件回顾分析该医2004年1月至2005年12月间发生于ICU与呼吸内科所有送检痰标本革兰阴性菌的分布及其主要分离菌铜绿假单胞菌的耐药性变迁。结果在2年中,ICU痰标本革兰阴性菌的前几位分别为铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌、肺炎克雷伯菌、脑膜败血黄杆菌。呼吸内科痰标本所分离革兰阴性菌的前几位分别为铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌、大肠埃希菌、嗜麦芽窄食单胞菌。铜绿假单胞菌在ICU的分离率从2004年的31.0%(92/617)上升到2005年的36.0%(257/713),在呼吸内科的分离率从2004年的23.0%(170/741)上升到2005年的25.0%(530/2118)。两个病区痰标本所分离的铜绿假单胞菌对16种抗菌药的耐药率均大于50%,仅对其中6种的耐药率每年均低于50%。但也呈逐年递增的趋势,分别为:头孢他啶38.1%-39.0%、庆大霉素13.1%-18.0%、妥布霉素7.2%-12.4%、头孢哌酮/舒巴坦10.2%-12.5%,等。结论两个科室革兰阴性菌的临床分离率在逐年增加,其主要感染菌铜绿假单胞菌在两个病区之间的耐药性均较高,差异存在着显著性。Objective To provide reasonable clinical prevention and treatment,we compared the separability of gram negaitive organisms and the drug resistance of its main isolated Pseudomonas aeruginosa （Pa） from lower respiration tract in ICU and respiration department in our hospital. Method Used WHONET5 software to analyze the distribution of gram negative organisms and the variance of Pa＇s drug resistance from this two department from 2004.1 to 2005.12. Results During the two years , the top 5 gram negative organisms in ICU were Pa ,Acinetobacter baumannii ,Stenotrophomonas maltophilia ,Klebsislla pneumoniae, Chromobacterium meningosepticum, but Pa, Acinetobacter baumanii, Klebsislla pneumoniae, Eschierichia coli, Stenotrophomanas maltophilia in respiration department. The grade effciency of Pa in ICU was 31.0% （92/617） in 2004 and 36.0% （ 257/713 ） in 2005 ,while in respiration was 23.0% （ 170/741 ） and 25.0% （530/2118）. The drug resistance efficiency of the Pa against 16 different antibacterial were all exceeded 50% ,from this two departments. Only 6 antibacterial were under 50% ,they were Caftazidime 38.1% - 39.0% ,Gentamicin 13.1% - 18.0% ,Tobramycin 7.2% - 12.4%, Cefoperazone/ Sulbactam 10.2% - 12.5% ,respectively. But its trend was still increasing with years . Conclusions The clinical grade efficiency of gram negative organisms in the two department is increasing with years . Their main bacteria Pa all has high drug resistance. And the data has striking dissimilarity.

关 键 词：铜绿假单胞菌 分离率 分布情况 耐药性分析 

分 类 号：R378[医药卫生—病原生物学]