ICU革兰阴性杆菌感染监测  

Monitoring of gram-negative bacilli infections in ICU

作　　者：王洪梅[1] 孙迎娟[2] 徐海凌[1] 

机构地区：[1]青岛大学医学院附属医院供应室,山东青岛266003 [2]青岛大学医学院附属医院感染管理科,山东青岛266003

出　　处：《中华医院感染学杂志》2013年第17期4286-4288,共3页Chinese Journal of Nosocomiology

基　　金：青岛市科技计划公共领域支撑项目(11-2-1-1-nsh)

摘　　要：目的调查ICU患者革兰阴性杆菌感染及耐药趋势,为临床合理使用抗菌药物提供科学依据。方法分析ICU感染患者2011年7月1日-2012年6月30日送检的各种标本分离到的革兰阴性杆菌分布及药敏检测结果。结果共分离出革兰阴性杆菌1056株,占63.5%,大多数感染源于呼吸道,占77.9%;分离率居前5位的依次是铜绿假单胞菌占33.2%、肺炎克雷伯菌占14.4%、鲍氏不动杆菌占13.6%、大肠埃希菌占9.7%和褪色沙雷菌占7.4%;肺炎克雷伯菌和大肠埃希菌产ESBLs比率分别为53.9%和61.8%;革兰阴性杆菌对临床常用抗菌药物的耐药严重,仅对碳青酶烯类、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦保持较高抗菌活性。结论 ICU患者感染革兰阴性杆菌耐药严重,加强临床感染革兰阴性杆菌分布及耐药监测对指导临床合理用药有积极意义。OBJECTIVE To investigate the distribution and antibiotics resistance of gram-negative bacilli in intensivecare unit （ICU） and direct clinical medication. METHODS The distribution and antibiotic susceptibility of gram-negative bacilli isolated from various specimens of infected patients in ICU delivered from July 1,2011 to June 30,2012 were investigated. RESULTS A total of 1056 strains of pathogens were isolated,most of which were infectedin the respiratory tract, accounting for 77. 9% ; the predominant ones were Pseudomonas aeruginosa （33. 2%）,Klebsiella pneumoniaedA. 4%）,Acinetobacter baumannii （13. 6%）,Escherichia coli （9. 7%） and Serratia Marc-essens （7. 4%） ; the ESBL-producing strains of K. pneumonias and E, coli accounted for 53. 9% and 61. 8% respectively; gram-negative bacilli were resistant to the common antibiotics and maintained a high antimicrobial activity for carbopenems,cefoperazone-sulbactam and piperacillin-tazobactam. CONCLUSION The gram-negativepathogenic bacteria in ICU present multidrug resistance. It is important to carry out surveillance of distributionand antimicrobial resistance of gram-negative bacilli so as to reasonably use antibiotics.

关 键 词：重症监护病房 革兰阴性杆菌 感染 耐药性 

分 类 号：R378[医药卫生—病原生物学]