ICU住院患者感染病原菌分布及耐药性分析  

Distribution and Drug resistance of Pathogenic Bacteria in ICU

作　　者：李爱娟[1] 吴宗宝[1] 张传飞[1] 庞佩芬 

机构地区：[1]浙江省天台县人民医院检验科,浙江天台县317200

出　　处：《中华医院感染学杂志》2010年第18期2850-2852,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解和探讨重症监护病房(ICU)住院患者感染的主要病原菌及耐药性现状与变迁,为临床诊断与治疗提供实验室依据。方法对2006年1月-2008年12月ICU送检的各类标本中检出的病原菌,采用全自动细菌鉴定仪VITEK32进行细菌鉴定和药敏试验,结合K-B药敏试验方法。结果共分离出病原菌688株,以革兰阴性杆菌为主,占49.0%,革兰阳性球菌占7.0%,真菌检出率44.0%;检出率高的前3位病原菌依次为鲍氏不动杆菌、肺炎克雷伯菌、铜绿假单胞菌。结论在ICU内细菌以革兰阴性杆菌和真菌为主,大多数病原菌对青霉素、氨苄西林耐药,而对万古霉素、亚胺培南、哌拉西林/他唑巴坦药物敏感性较好,病原菌总体耐药情况呈上升趋势,治疗上应根据药敏结果选择敏感抗菌药物,避免滥用。OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in ICU so as to provide the evidence for clinical diagnosis and treatment.METHODS From Jan 2006 to Dec 2008,the identification of species from ICU was performed with VITEK32 bacteria identification and drug sensitivity analytical system.The bacterial susceptibility testing was done by Kirby-Bauer method.RESULTS Among the isolated 688 strains of bacteria,Gram-negative bacilli,Gram-positive cocci and fungi accounted for 49.0%,7.0% and 44.0%,respectively.The top 3 pathogens were Acinetobacter baumanii,Klebsiella pneumoniae and Pseudomonas aeruginosa.CONCLUSION The Gram-negative bacilli and fungi are main pathogens in ICU,and most of them are drug resistant to penicillin and ampicillin,but the susceptibilities to vancomycin,imipenem and piperacillin/tazobactam are good.The drug resistant rate keeps an upward tendency,so the selection of antibiotics should be based on the drug sensitivity test.

关 键 词：重症监护病房 感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]