ICU下呼吸道感染革兰阴性杆菌的分布及耐药性研究  

Study on distribution and drug resistance of gram-negative bacillus in lower respiratory tract infections in ICU

作　　者：王舜尧[1] 赵依侬 李小青[3] 林建清[4] 

机构地区：[1]衢州市人民医院重症医学科,浙江衢州324000 [2]衢州衢江区人民医院重症医学科,浙江衢州324000 [3]衢州常山县人民医院重症医学科,浙江衢州324200 [4]衢州江山市人民医院重症医学科,浙江江山324100

出　　处：《中华医院感染学杂志》2013年第23期5813-5814,5817,共3页Chinese Journal of Nosocomiology

基　　金：衢州市科技局科研基金项目(20121074)

摘　　要：目的研究下呼吸道感染革兰阴性杆菌的分布及其耐药性,为临床预防治疗提供参考。方法回顾性分析医院ICU于2009年12月-2012年12月收治的230例医院获得性下呼吸道感染患者的临床资料,分析其病原菌分布和耐药性。结果共检出革兰阴性杆菌256株,其中肺炎克雷伯菌80株占31.3%,铜绿假单胞菌54株占21.1%,洋葱伯克霍尔德菌30株占11.7%,大肠埃希菌28株占10.9%,居前4位;革兰阴性杆菌对头孢哌酮/舒巴坦、阿米卡星、亚胺培南耐药率较低<30.0%,对头孢他啶、头孢曲松、头孢噻肟、氨苄西林、呋喃妥因、四环素等药物的耐药率100.0%。结论 ICU的下呼吸道感染革兰阴性杆菌的病原菌分布较集中,且耐药性较为严重,临床上应合理应用抗菌药物治疗,防止耐药菌的传播。OBJECTIVE To study the distribution and drug resistance of gram-negative bacillus in lower respiratory tract infections, and to provide the reference for clinical prevention and treatment. METHODS A retrospective analysis was conducted on the clinical data of 230 patients with lower respiratory tract infections in the ICU of our hospital from Dec. 2009to Dec. 2012, and the distribution and drug resistance of the pathogens were analyzed. RESULTS A total of 256 strains of gram negative bacilli were detected, of which 80 strains of Klebsiella pneumon- iae （31.3%）, 54 strains of Pseudornonasaeruginosa （21.1%）, 30 strains of Burkholderia cepacia （11.7%）, 28 strains of Escherichia coli （10.9%） were detected, which were the top four bacteria. The drug resistance rates of gram negative bacilli to eefoperazone/sulbactam, amikacin, impenem were low （〈30%）, and to the drugs such as ceftazidime, eeftriaxone, eefotaxime, ampicillin, nitrofurantoin, tetracycline were as high as 100 % respectively. CONCLUSION The distribution of gram-negative bacillus in lower respiratory tract infections in IFU is very concentrated, and the drug resistance is high. The clinical application of antimicrobial drugs should be rational in order to prevent the spread of drug-resistant bacteria.

关 键 词：下呼吸道感染 革兰阴性杆菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]