重症监护室常见革兰阴性杆菌分布及耐药性  

Distribution and drug resistance of common gram-negative bacilli in an intensive care unit

作　　者：崔兰英[1] 路娟[1] 宋熙瑶[1] 罗文涛[1] 刘文博[1] 赵金英[1] 

机构地区：[1]哈尔滨医科大学附属第一医院,黑龙江哈尔滨150001

出　　处：《中国感染控制杂志》2011年第5期373-375,共3页Chinese Journal of Infection Control

摘　　要：目的了解某院重症监护室(ICU)常见革兰阴性(G^-)杆菌的分布及其耐药情况。方法回顾性分析该院ICU病区2008 2010年分离的常见G^-杆菌种类及其药敏试验结果。细菌鉴定和药敏试验,采用法国生物梅里埃公司(bio-Merieux)VITEK-2全自动微生物分析仪进行。应用WHONET5.5软件对数据进行统计分析。结果 1 551株G^-杆菌标本来源以痰液为主(68.06%);常见G^-杆菌以鲍曼不动杆菌所占比率最大(25.40%,394株),其次为肺炎克雷伯菌(21.66%,336株)、大肠埃希菌(16.76%,260株)和铜绿假单胞菌(15.86%,246株)等;产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希菌株数分别为198株(58.93%)和174株(66.92%)。常见G^-杆菌敏感性较好的抗菌药物主要为哌拉西林/他唑巴坦(耐药率19.23%～31.73%)、亚胺培南(耐药率9.23%～37.40%)、头孢哌酮/舒巴坦(耐药率14.88%～32.23%)、阿米卡星(耐药率22.92%～27.66%)。结论 ICU病区的常见G杆菌多重耐药现象严重,临床应根据药敏试验结果合理使用抗菌药物,以减少耐药菌株的产生。Objective To investigate the distribution and drug resistance of common gram negative bacilli in inten-sive care unit （ICU） in a hospital. Methods The species and drug susceptibility test of the common gram negative bacilli isolated from ICU between 2008 and 2010 were analyzed retrospectively. Bacteria were identified and per-formed antimicrobial susceptibility test with VITEK 2 （bic-Merieux） system. The date were analyzed by the soft- ware ＂WHONET 5.5＂. Results Of 1 551 gram-negative bacilli isolates, 68.06% were isolated from sputum; among the common gram-negative bacilli, the first one was Acinetobacter 5aumannii, which accounting for 25.40% （394 strains）, followed by Klebsiella pneumoniae （21.66% ,336 strains）, Escherchia coli （16. 76% ,260 strains）, and Pseudomonas aeruginosa （15.86%, 246 strains）, etc; 198（58. 93%） strains of Klebsiella pneumoniae and 174 （66. 92%） of Escherlchia coli were extended-spectrum β-lactamase producing strains. The common gram negative bacilli had very low resistant rates to piperacillin/tazobactam, imipenem, cefoperizone/sulbactam and amikacin, the resistant rates was 19. 23% - 31.73%0,9. 23% - 37. 40%, 14. 88% - 32.23%, and 22. 92% - 27. 66%, respective ly. Conclusion Multi drug resistance among the common gram negative bacilli in ICU is very serious . In order to reduce the emergence of drug-resistant bacterial strain, it is important to use antimicrobial agents correctly based on drug susceptibility test result.

关 键 词：重症监护室 革兰阴性杆菌 抗药性 微生物 合理用药 

分 类 号：R969.3[医药卫生—药理学]