ICU导尿管相关性尿路感染的病原菌分布及耐药性分析  

Distribution and Resistance Analysis of Pathogenic Bacteria Causing Catheter Associated Urinary Tract Infection in ICU

作　　者：邵俊 郑瑞强 林华 卢年芳 於江泉 

机构地区：[1]江苏省苏北人民医院 扬州大学临床医学院ICU,江苏省扬州市225001

出　　处：《医学理论与实践》2013年第22期2941-2942,2947,共3页The Journal of Medical Theory and Practice

基　　金：江苏省"333高层次人才培养工程"基金资助(2011-3)

摘　　要：目的:探讨ICU导尿管相关性尿路感染的病原学分布及耐药性,为临床合理使用抗菌药物提供依据。方法:回顾性对2009年7月-2013年6月入住我院ICU确诊导尿管相关性尿路感染的患者送检的尿液标本培养及药敏结果进行统计分析。结果:4 558份尿标本共检出226株致病菌,其中革兰氏阴性菌138株,占61.06%,革兰氏阳性菌株57株,占25.22%,真菌株31株,占13.72%。排名前五位的病原菌依次是鲍曼不动杆菌、肺炎克雷伯氏菌、大肠埃希菌、粪肠球菌、白色念珠菌。鲍曼不动杆菌对大部分药物耐药性均>50%,耐药性在50%以下的药物仅有头孢哌酮/舒巴坦、美罗培南、亚胺培南/西司他丁、复方新诺明。结论:革兰氏阴性菌仍是ICU导尿管相关性尿路感染的主要致病菌,鲍曼不动杆菌已上升为第一位致病菌,且耐药情况严重,依据药敏结果合理使用抗菌药物以及严格执行手卫生非常重要。Objective ：To explore the distribution and resistance of pathogenic bacteria causing catheter associated uri-nary tract infection in ICU so as to guide the clinical rational use of antibiotics .Methods ：Urine culture and its drug sus-ceptibility results of patients who were diagnosed catheter associated urinary tract infection were analyzed retrospective-ly from July 2009 to June 2013 in ICU of Subei People’s Hospital of Jiangsu Province .Results：226 strains of pathogenic bacteria was detected from 4558 urine specimens ,of which 138 strains of gram-negative bacteria （61 .06% ） ,57 strains of gram-positive bacteria（25 .22% ） ,31 fungi strains（13 .72% ） .Top five of pathogenic bacteria was followed by acine-tobacter baumannii ,pneumonia klebsiella ,Escherichia coli ,Enterococcus faecalis ,candida albicans .Resistance of acine-tobacter baumannii in most drug was 〉50% .Under 50% of the resistance was just cefoperazone/sulbactam ,meropen-em ,imipenem/Cilastatin ,SMZ/TMP .Conclusion：Gram-negative bacteria is still the main pathogenic bacteria of catheter associated urinary tract infections in ICU .Acinetobacter baumannii has risen to the first pathogenic bacteria ,and drug resistance is very severe .Rational use of antibiotics and good hand hygiene is very important according to the results of drug susceptibility .

关 键 词：导尿管相关性尿路感染 病原菌 抗菌药物 耐药性 重症监护病房 

分 类 号：R691.3[医药卫生—泌尿科学]