ICU胆道感染病原菌的临床分布及耐药性分析  

Clinical distribution and drug resistance of pathogens causing biliary tract infections in ICU

作　　者：甘泉[1] 杜朝晖[1] 李建国[1] 

机构地区：[1]武汉大学中南医院重症医学科,湖北武汉430071

出　　处：《中华医院感染学杂志》2013年第4期925-927,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析医院重症监护病房(ICU)临床病原菌来源分布及耐药性,以指导临床经验性使用抗菌药物。方法对2011年ICU胆汁培养物进行病原菌培养与鉴定,药敏试验采用K-B纸片法,使用WHONET 5.4软件进行耐药性分析。结果 ICU胆汁来源的菌株以革兰阴性菌为主,其中前4位依次为鲍氏不动杆菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌,分别占35.00%、20.00%、10.00%、10.00%;肠杆菌科菌株对氨基糖苷类、酶抑制剂类和碳青霉烯类耐药率最低,非发酵菌菌株对头孢哌酮/舒巴坦耐药率最低。结论在无明确细菌学结果的前提下,针对临床诊断的胆道感染可经验性使用头孢哌酮/舒巴坦针剂抗感染,再根据培养及临床治疗随时调整抗菌药物治疗。OBJECTIVE To investigate the clinical distribution and antibiotic resistance of the pathogens isolated from bile of the patients in ICU so as to guide the clinical empirical treatment.METHODS The specimens obtained from the bile of the ICU patients in 2011 were cultured for pathogens,the isolated pathogens were identified,the drug susceptibility testing was performed by Kirby-Bauer method,and the data were analyzed by WHONET 5.4 software.RESULTS The gram-negative bacteria were the predominant pathogens causing the biliary tract infections in the ICU,among which Acinetobacter baumannii,Escherichia coli,Klebsiella pneumonia and Pseudomonas aeruginosa were the top four species with the isolation rates of 35.00%,20.00%,10.00%,and 10.00%,respectively.The antibiotic resistance rates of the Enterobacteriaceae to aminoglycosides,enzyme inhibitors,and carbapenems were the lowest,while the antibiotic resistance rate of the non-fermenting bacteria to cefoperazone-sulbactam was the lowest.CONCLUSION On the premise of uncertain pathogens causing biliary tract infections in the ICU,it is necessary to firstly use cefoperazone-sulbactam for the empirical treatment and then change the therapy according to the clinical responses and culture result when necessary.

关 键 词：胆道感染 细菌 耐药性 分析 

分 类 号：R378[医药卫生—病原生物学]