ICU连续8年革兰阴性杆菌的菌谱调查  

A Profile of Gram-negative Bacilli in ICU Ward During Eight Years:An Investigation

作　　者：年华[1] 褚云卓[1] 欧阳金鸣[1] 王倩[1] 

机构地区：[1]中国医科大学第一临床学院检验科,辽宁沈阳110001

出　　处：《中华医院感染学杂志》2008年第1期111-114,共4页Chinese Journal of Nosocomiology

基　　金：辽宁省教育厅课题基金资助项目(05L528)

摘　　要：目的了解8年来重症监护病房(ICU)的病原菌菌谱情况并对耐药结果进行分析,为ICU抗感染经验治疗提供实验依据。方法细菌鉴定应用VITEK2自动鉴定仪和API鉴定系统,药敏试验采用K-B纸片扩散法,并按照CLSI 2006年标准进行结果判定,耐药结果分析应用WHONET 5.4软件。结果ICU 8年共分离革兰阴性杆菌1492株,其中非发酵菌1146株,占76.8%,肠杆菌科细菌346株,占23.2%,排在前5位依次是铜绿假单胞菌、洋葱伯克霍尔德菌、鲍氏不动杆菌、嗜麦芽寡养单胞菌和大肠埃希菌,病原菌的耐药率较高并有逐年增高的趋势。结论ICU分离的病原菌菌谱以非发酵菌为主且病原菌种类更多更复杂,病原菌的耐药情况更严重,对ICU的病原菌菌株进行耐药性分析,不仅可指导临床治疗,而且能及时发现耐药菌株的暴发流行。OBJECTIVE To learn the profile of Gram-negative bacilli in ICU ward during the eight years and analyze the drug resistant rates in order to provide the basis for empirical treatment of infection. METHODS The bacteria were identified by VITEK-2 and API system. Antibiotic sensitivity test adopted Kirby-Bauer method. Data were analyzed by WHONET5.4 software. RESULTS Totally 1492 strains of Gram-negative bacilli were isolated from ICU ward, which included 1146 strains of non-fermentaters, accounted for 76. 8% and 346 strains of Enterobacteriaceae, accounted for 23.2 %. The first five bacteria were Pseudomonas aeruginosa, Burkholderia cepacia, Acinetobacter baumannii, Stenotrophomonas maltophilia, and Escherichia coli by turns. The drug resistant rates were higher and had the tendency of increase by years. CONCLUSIONS Non-fermentaters are the main organisms in ICU ward. The species of bacteria are diversified and the drug resistant rates of them are serious, which should be monitored not only because helping clinical therapy but also discovering the prevalence of drug resistant strains.

关 键 词：重症监护病房 耐药性 革兰阴性杆菌 

分 类 号：R378.2[医药卫生—病原生物学]