重症监护病房革兰阴性杆菌耐药监测分析  

Monitoring on drug resistance of Gram-negative bacilli in ICU ward

作　　者：孙悦波[1] 汪艳[1] 

机构地区：[1]辽宁省大连市友谊医院检验科,116001

出　　处：《中国公共卫生》2009年第5期616-618,共3页Chinese Journal of Public Health

摘　　要：目的了解重症监护病房(ICU)革兰阴性杆菌的分离率及耐药谱,为合理使用抗生素及院内感染监控提供依据。方法采用自动细菌鉴定仪(ATB-expression)进行细菌鉴定,Kirby-Bauer纸片法进行药敏试验;用WHONET5.4软件统计分析病原菌分离率及耐药率。结果ICU分离革兰阴性杆菌677株,其中铜绿假单胞菌占39.0%,鲍氏不动杆菌占17.0%,肺炎克雷伯菌占16.8%,嗜麦芽寡养单胞菌占11.4%,大肠埃希菌占4.3%。677株分离株中,产超广谱β-内酰胺酶(ESBLS)肺炎克雷伯菌占56.1%;产超广谱β-内酰胺酶(ESBLS)大肠埃希菌占24.1%。非发酵菌504株,占74.5%,耐药率较低抗生素有:头胞吡肟49.3%,美罗培南50.4%,哌拉西林/他唑巴坦51.8%,头胞他啶57.9%;发酵菌173株,占25.5%;发酵菌耐药率较低的抗生素有美罗培南0%,哌拉西林/他唑巴坦34.5%,丁胺卡钠45.3%,头胞吡肟54.3%,头胞他啶61.3%。结论重症监护病房革兰阴性杆菌感染中,非发酵菌占优势,铜绿假单胞菌分离率最高。Objective To learn the isolation rate and the profile of drug resistance of Gram-negative bacilli in ICU ward in order to provide the basis for rational administration of antibacterial and infection prevention. Methods Identification of bacteria was performed by ATB-expression system and the drug sensitivity test was conducted with Kirby-Bauer method. The detection rate and drug resistant rate were analyzed with WHONET 5.4 software. Results Totally 677 strains of Gram-negative bacilli were isolated from various clinical specimens in ICU ward from 2005 to 2007. The predominant pathogens were Pseudomonas aerations （ 39.0% ） , Acinetobacter Baumann （ 17.0% ）, Klebsiella pneumonia （ 16. 8% ）, Stenotrophomonas Maltophilia（ 11.4% ） ,Escherichia coli（4.3% ）. Among them,56. 3% Klebsiella pneumonia strains produced ESBLs ,24. 1% of Escherichia coli produced ESBLs. 504（74.5% ） strains of non-fermented were isolated. The antibiotic resiance of non-fermented strains to Caffeine, Meropenem, Piperacilli, Tazobacyam and Ceftazidime was 49.3% ,50. 4%, 51.8% and 57.9% ,respectively. The resistant rate of fermenter straines to Reopened, Piperacillin/Tazobactam, Amice, Caffeine and Ceftazidime was 0% ,34.5% ,45.3% ,54.3% and 61.3%, respectively. Condusion Gram-negative bacilli are main pathogen in ICU ward, non-fermented are predominant pathogen, and the detection rate of Pseudomnas are the highest.

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]