ICU医院获得性肺炎感染病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens causing hospital acquired pneumonia in intensive care unit

作　　者：龙盛双[1] 邱隆敏[1] 杨泽敏[1] 秦桂英[1] 谢容[1] 

机构地区：[1]遵义医学院附属医院医院感染管理科,贵州遵义563003

出　　处：《中华医院感染学杂志》2011年第8期1685-1687,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院重症监护病房(ICU)医院获得性肺炎感染细菌分布及耐药性,指导临床合理使用抗菌药物。方法对医院2009年ICU住院期间发生医院获得性肺炎患者的39份痰标本参照《全国临床检验操作规程》(第3版)的方法培养,细菌鉴定采用microscan-walkaway-40细菌鉴定/药敏分析系统,按照美国2009年CLSI判断标准进行。结果培养出细菌60株,以革兰阴性菌为主,占83.3%,排名前5位的分别是鲍氏不动杆菌、铜绿假单胞菌、耐甲氧西林金黄色葡萄球菌(MRSA)、肺炎克雷伯菌、大肠埃希菌;鲍氏不动杆菌为多药耐药菌,对第三、四代头孢耐药率高。结论 ICU医院获得性肺炎感染细菌仍以革兰阴性菌为主,但呈多药耐药,应定期对ICU医院感染菌分布和耐药性进行监测,以指导临床早期合理选用抗菌药物,避免盲目用药,减少新耐药菌产生。OBJECTIVE To determine the organisms causing hospital acquired pneumonia in an intensive care unit（ICU） and to study their antimicrobial susceptibility pattern.METHODS A total of 39 cases of hospital acquired pneumonia in an ICU during of hospital stay in 2009 and their sputum samples were included in the study.The culture of bacteria were carried out by National Clinical Laboratory Operating Instruction（the 3rd Edition） and the identification as well as susceptibility test of bacteria were detected by microscan-walkaway-40 system and judged by criteria of Clinical and Laboratory Standard Institute of America（CLSI）2009.RESULTS From 39 samples,60 strains bacteria were isolated and the Gram-negative bacteria were common（83.3%）.The first five commonest organisms were Baumanii,Pseudomonas aeruginosa,methicillin resistant Staphylococcus aureus（MRSA）,Klebsiella pneumoniae,and Escherichia coli.Susceptibility test demonstrated that the Baumanii was multidrug resistant,both of them were poor susceptibility to the third and fourth generation of cephalosporins.CONCLUSION Gram-negative bacteria with multi-drug resistance were the commonest organism causing hospital acquired pneumonia in an ICU.Regularly monitoring the resident microbial flora and their antimicrobial susceptibility pattern is necessary for formulating a rational antibiotic application policy and reducing the drug resistant strains.

关 键 词：重症监护病房 医院获得性肺炎 病原菌 分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]