重症监护病房患者下呼吸道感染非发酵菌菌群的分布及耐药性分析  

Distribution and drug resistance of nonfermentative bacteria in patients with lower respiratory tract infection in intensive care unit

作　　者：王梅芬[1] 明亮[1] 张傅山[1] 徐珉[1] 叶亚菲[1] 黄凯达[1] 朱庆华[1] 王万海[1] 

机构地区：[1]郑州大学第一附属医院,郑州450052

出　　处：《山东医药》2013年第10期13-15,共3页Shandong Medical Journal

基　　金：郑州大学第一附属医院青年创新项目(201101)

摘　　要：目的观察重症监护病房(ICU)患者下呼吸道感染非发酵菌菌群的分布特点及耐药情况,为临床治疗提供依据。方法对239例ICU患者的痰标本进行细菌培养、鉴定和药物敏感试验。结果 239例痰标本中,79例菌群正常,另160例共检出177株病原菌,其中革兰阴性杆菌136株(76.8%),包括非发酵菌103株,占所有感染菌的58.2%,占革兰阴性菌的75.7%。非发酵菌中,以鲍曼不动杆菌和铜绿假单胞菌为主,占88.3%;还发现嗜麦芽窄食单胞菌(5.8%)、恶臭假单胞菌(3.9%)和荧光假单胞菌(1.9%)。在药物敏感方面,非发酵菌多为多重耐药菌,甚至为泛耐药菌。结论 ICU患者下呼吸道感染的病原菌以非发酵菌为主,呈多重耐药趋势,应加强ICU病原菌及耐药性监测,为临床合理使用抗菌药物提供参考依据。Objective To investigate the distribution and antibiotic resistance of nonfermentative bacteria among patients with lower respiratory tract infection in intensive care unit （ ICU ）. Methods Bacterial culture, identification, and drug sensitivity test of sputum specimens of 239 patients in ICU were conducted. Results A total of 177 pathogens were i- dentified from the sputum in 160 patients, including the gram-negative bacteria（76.8% ）. Among the gram-negative bacte- ria, the nonfermentative bacteria covered 75.7% , and acinetobacter baumannii and pseudomonas aeruginosa were the main nonfermentative bacteria （88.3%）. Meanwhile, there were stenotrophomonas maltophilia （5.8%） , pseudomonas putida （3.9%） and pseudomonas fluorescens （ 1.9% ）. In the sensitive aspects of antibiotics, most of the non_fermentative bacte- ria were multidrug-resistant and some of them were pandrug-resistant. Conclusions The nonfermentative bacteria are the major pathogens and most of them are muhidrug-resistant. The monitoring of drug-resistance of pathogenic bacteria should be strengthened in ICU, which could provide reference for the clinical rational use of antibiotics.

关 键 词：非发酵菌 药物耐受 细菌 重症监护病房 

分 类 号：R446.5[医药卫生—诊断学]