ICU医院获得性肺炎病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens causing hospital-acquired pneumonia in ICU

作　　者：侯德凤[1] 姜友珍[1] 刘海燕[1] 

机构地区：[1]广西壮族自治区南溪山医院检验科,广西桂林541002

出　　处：《中华医院感染学杂志》2013年第1期27-29,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨ICU医院获得性肺炎(HAP)病原菌分布及耐药性分析,为临床合理使用抗菌药物提供依据。方法回顾性分析2010年1月-2011年12月ICU HAP患者痰标本分离的病原菌及其耐药性。结果共检出病原菌302株,其中革兰阴性杆菌211株占69.9%,真菌66株占21.8%,革兰阳性球菌25株占8.3%,分离率排前5位的病原菌依次为肺炎克雷伯菌54株占17.9%,铜绿假单胞菌49株占16.2%,大肠埃希菌42株占13.9%,白色假丝酵母菌38株占12.6%,鲍氏不动杆菌25株占8.3%;革兰阴性杆菌对亚胺培南、阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦有较好的敏感性,白色假丝酵母菌对临床常用的抗真菌药物仍保持较高的抗菌活性,革兰阳性球菌未发现对万古霉素耐药株。结论 ICU HAP病原菌以革兰阴性杆菌为主,且多为多药耐药菌株,应加强耐药性的监测。OBJECTIVE To investigate the distribution and drug resistance of the pathogens causing hospital-acquired pneumonia （HAP） in ICU so as to provide basis for the clinical reasonable use of antibiotics. METHODS The pathogens, which were isolated from the sputum specimens obtained from the HAP patients from Jan 2010 to Dec 2011 ,were retrospectively analyzed,the drug resistance was analyzed as well. RESULTS A total of 302 strains of pathogenic bacteria were isolated, including 211 （69.9%） strains of gram-negative bacilli, 66 （21.8%） strains of fungi, and 25 （8.3%） strains of gram-positive cocci. The top 5 pathogens isolated were Klebsiella pneurnoniae （54 strains, 17. 9%）, Pseudomonas aeruginosa （49 strains, 16. 2%）, Escherichia coli （42 strains, 13. 9%）, Candida albicans （38 strains, 12. 6%）, Acinetobacter baumannii （25 strains, 8. 3%） ; the gram-negative bacilli were highly sensitive to imipenem, amikacin, cefoperazone/sulbactam, and piperacillin/tazobactam, C. albicans maintained high resistanle against clinical common antibiotics, no strains of vancomycin-resistant gram-positive cocci were detected. CONCLUSION The gram-negative bacilli are the main pathogens causing HAP in ICU, most of which are multidrug-resistant strains,it is necessary to strengthen the monitoring of drug resistance.

关 键 词：重症监护病房 医院获得性肺炎 病原菌 耐药性 

分 类 号：R181.32[医药卫生—流行病学]