ICU下呼吸道感染病原菌分布与耐药现状分析  

Distribution and antibiotic resistance of pathogenic bacteria causing lower respiratory tract infection in ICU

作　　者：金晓冰[1] 邓敏[2] 邹俊宁[2] 江新姣[2] 吴艳艳[2] 

机构地区：[1]鄂州市中心医院感染管理科,湖北鄂州436000 [2]华中科技大学同济医学院附属协和医院感染管理科,湖北武汉430030

出　　处：《中华医院感染学杂志》2011年第5期998-1000,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解重症监护病房(ICU)患者下呼吸道感染的病原菌分布和耐药谱,为临床治疗提供依据。方法入选2008年1月-2009年6月入住ICU下呼吸道感染患者,进行深部痰液病原菌培养,分析病原菌分布情况和耐药性。结果革兰阴性杆菌是下呼吸道感染的主要病原菌,占66.9%,以鲍氏不动杆菌占优势,为31.6%;革兰阳性球菌占10.3%,以金黄色葡萄球菌为主,占8.1%;真菌感染占22.8%,除真菌耐药率较低外,其他病原菌均有较高耐药性,多药耐药鲍氏不动杆菌检出率达69.8%。结论 ICU下呼吸道感染病原菌的菌群分布发生了变化,真菌感染率上升,多药耐药菌增多,临床医师需密切关注分离菌的变迁及耐药情况,合理使用抗菌药物。OBJECTIVE To investigate the distribution and antibiotic resistance status of pathogenic bacteria from lower respiratory tract in patients of intensive care unit （ICU） in hospital, and provide basis for rational selection of clinical drugs. METHODS Totally 89 cases of lower respiratory infection admitted to the ICU from Jan 2008 to Jun 2009 were reviewed. Pathogens in the sputum were isolated and indenified,and the distribution of pathogenic bactieria and their drug resistance profile were analyzed. RESULTS 66. 9~ of pathogenic bacteria were Gram- negative ones, among which Acinetobater baumannii occupy 31.6 ~, 10.3 ~ were Gram-positive bacteria, Staphy- lococcus aureus （8. 1%）was the most prominent bacteria. Fungi accounted for 22.8~. All pathogenic bacteria showed high resistance to the antibiotics but fungi. Multl-drug resistant （MDR） Acinetobater baumannii were test out with 69.8 % occurrence. CONCLUSION The pathogenic bacteria and their resistance to the antibiotic have been changed in ICU. The fungal infection rate is increased and there is an increasing trend in the detection rate of MDR. Clinicians should pay close attention to the changes and resistance of pathogenic bacteria and use antibiotics rationally.

关 键 词：重症监护病房 下呼吸道感染 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]