2001～2006年医院重症监护病房痰培养中鲍氏不动杆菌、肺炎克雷白杆菌耐药性的变迁  

Drug resistance change of K lebsiella pneumonia and Acinetobacter baumannii in intensive care unit from 2001 to 2006

作　　者：刘坤玲[1] 于亮[1] 屈文东[1] 高丽[1] 刘伦[1] 

机构地区：[1]泰山医学院附属泰安医院,山东泰安271000

出　　处：《泰山医学院学报》2007年第12期947-950,共4页Journal of Taishan Medical College

摘　　要：目的探讨某院重症监护病房（ICU）2001—2006年患者痰培养中主要病原菌种类及对常用抗菌药物耐药谱的变化，为临床和医院感科管理提供第一手资料。方法系统分析2001—2006年ICU病房痰培养中各种细菌的种类以及耐药性的变迁。结果2001～2004年ICU病房痰培养的细菌以铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷白杆菌分离率为最高。2006年金黄葡萄球菌分离率超过鲍氏不动杆菌。各细菌耐药性呈增加的趋势。产超广谱β-内酰胺酶肺炎克雷白杆菌的耐药性较非产酶组明显增加。结论目前ICU病房细菌以铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷白杆菌和耐甲氧西林金黄葡萄球菌为痰中主要分离细菌，耐药情况严重，应采取必要措施，减少细菌耐药的发生。Objective： To study the drug resistance change of Pseudomonas Aeruginosa in intensive care unit ICU from 2001 -2006 and provide the first-hand information about the clinical preventive and therapeutic measures. Methods： K lebsiella pneumonia and Acinetobacter baumannii antimicrobial susceptibility tests to commonly used antibiotics were performed from 2001 to 2006. Results ： The most frequent isolates were Pseudomonas Aeruginosa, K lebslella pneumonia and Acinetobacter baumannii in 2001- 2004. Staphylococcus aureus（SA）, were more than Acinetobacter baumannii in 2006, were the major isolated bacteria in the sputum of the ICU patients. The incidence of drug resistance increased yearly in K lebsiella pneumonia and Acinetobacter baumannii, and the K lebsiella pneumonia with producing extended spectrum β- lactamases （ESBLs） had higher resistence for antimicrobial than that without producing ESBLs. Conclusion： The study shows that Pseudomonas Aeruginosa, K lebsiella pneumonia, Acinetobacter baumannii and Staphylococcus aureus （ SA ） were the major pathogens in the ICU , and the pathogens show the high drug resistance. Doctors should pay more attention to the analysls of the bacterial resistance profile in order to decrease the incidence of drug resistance and the proper use of the antibiotics.

关 键 词：ICU 耐药 鲍氏不动杆菌 肺炎克雷白杆菌 

分 类 号：R446.5[医药卫生—诊断学]