ICU相关性肺部感染的病原菌分布及其耐药性分析  

Analysis on pathogenic bacteria distribution and drug resistance of ICU associated pulmonary infection

作　　者：杨晓丽[1] 张丽[1] 马健生[1] 刘淑娟[1] 赵颖贤[1] 

机构地区：[1]宁夏固原市人民医院ICU科,宁夏固原756000

出　　处：《中华医院感染学杂志》2013年第23期5811-5812,5822,共3页Chinese Journal of Nosocomiology

基　　金：宁夏自然科学基金资助项目(NZ13242)

摘　　要：目的探讨ICU相关性肺部感染的病原菌分布,并分析其病原菌的耐药性。方法选择住院的ICU相关性肺部感染患者104例为研究对象,采集患者的支气管灌洗液、呼吸道分泌物及痰液标本,对分离出的病原菌进行统计,并对主要病原菌行药敏试验。结果共分离出病原菌112株,其中肺炎克雷伯菌29株占25.9%,明显高于其他病原菌,差异有统计学意义(P<0.05);肺炎克雷伯菌对磺胺甲噁唑/甲氧苄啶耐药性最高为75.9%,显著高于对其他抗菌药物的耐药率(P<0.05);大肠埃希菌对磺胺甲噁唑/甲氧苄啶耐药性最高为86.7%,显著高于对其他抗菌药物的耐药率(P<0.05)。结论 ICU相关性肺部感染的病原菌分布以肺炎克雷伯菌、大肠埃希菌为主,该两种病原菌均对磺胺甲噁唑/甲氧苄啶有很高的耐药性,治疗过程中应及时行病原菌培养及动态监测病原菌的耐药性,提高抗感染治疗的成功率,根据病原菌的药敏结果选择合适的抗菌药物,促进患者早日康复。OBJECTIVE To investigate the pathogen distribution of ICU related pulmonary infection, and analyze its pathogen resistance. METHODS A total of 104 cases of patients with ICU related pulmonary infections in our hospital were enrolled. Bronchoalveolar lavage fluid of patients, respiratory secretions and sputum samples were collected, the number of pathogens isolated was calculated for each pathogen, and the drug susceptibility test was performed for main pathogens. RESULTS A total of 112 pathogen strains were isolated, among which, 29 strains were Klebsiella pneumoniae, accounting for 25.9%, significantly higher than other pathogens, with a significant difference （P 〈 0. 05 ）. K. pneumoniae had the highest resistance rate to sulfamethoxazole/trimethoprim （75.9 %）, significantly higher than that to other antibiotics （P〈0.05）. Escherichia coli had the highest resist-ance rate to sulfamethoxazole/trimethoprim （86. 7%）, significantly higher than that to other antibiotics （P〈0.05）. CONCLUSION Pathogens causing ICU associated pulmonary infection were mainly K. pneumoniae, and Escherichia coli, with high resistance to sulfamethoxazole/trimethoprim. Pathogen culture should be timely performed as well as dynamic monitoring of pathogen resistance in the treatment process, in order to improve the success rate of anti-infection therapy. And antibiotic agents should be selected appropriately based on drug suscep-tibility test results to promote early recovery.

关 键 词：重症监护病房 相关性肺部感染 病原菌 分布 耐药性分析 

分 类 号：R378[医药卫生—病原生物学]