ICU患者中心静脉导管相关性血流感染病原菌分布及耐药性分析  

作　　者：徐黔宁[1] 喻长法[1] 段达荣[1] 金高明[1] 肖小荣 

机构地区：[1]浙江省台州市第一人民医院,318020

出　　处：《浙江临床医学》2015年第1期26-27,共2页Zhejiang Clinical Medical Journal

基　　金：浙江省台州市科技局基金（2011A33190）

摘　　要：目的探讨ICU患者中心静脉导管相关性血流感染（CRBSI）病原菌的分布特点及其耐药性，为临床合理防治CRBSI提供参考依据。方法回顾性分析2008年1月至2012年12月ICU中心静脉留置治疗患者感染的发生情况，并对其痛原菌及耐药特点进行分析。结果共栓出197株病原菌，其中革兰阴性杆菌占48．22％，革兰阳性球菌占40．61％，真菌占11．17％。药敏结果显示，鲍氏不动杆菌和铜绿假单胞菌的耐药率普遍较高；对大肠埃希菌和肺炎克雷伯菌耐药率低的有头孢替坦、哌拉西林／他唑巴坦、头孢哌酮，舒巴坦和阿米卡星，未检出耐亚胺培南菌株；对阳性球菌耐药率低的有利福平和呋喃妥因，未检出耐替加环素、替考拉宁和万古霉素菌株。结论中心静脉留置导管较易引起血流感染，引起血流感染病原菌主要以表皮葡萄球菌和鲍氏不动杆菌为主，且耐药性严重。Objective To investigate the distribution of pathogen and drug resistance analysis for Catheter-related bloodstream infection （ CRBSI ） in ICU, to provide evidence for the guidance of clinical rational administration CRBSI.Metbods We examined records with catheter- related blood stream infection from Jan. 2008 to Dec. 2012 in ICU, and the pathogens and bacterial resistance research were also included.Results A total of 197 strains of pathogenic bacteria was detected, including gam-negative bacillus （ 48.22% ） , gain-positive cocci （ 40.61% ） and fungus （ 11.17% ） .Drug susceptibility showed the generally higher drug resistance to Acinetobacter aumannii and Pseudomonas aeruginosa. Escherichia coli and Klebsiella pneumonia were sensitive to cefotetan, piperacillin/tazobactam, Cefoperazone/sulbactam, amikacin and imipenem. Gram-positive bacteria were sensitive to rifampicin, nitrofurantoin, tigecycline, teicoplanin and vancomycin. Conclusion Venous terization was easy to cause blood stream infection, Staphylococcus epidermidis and Acinetobacter baumannii were the commonest pathogens and its resistance rate was very high.

关 键 词：中心静脉导管 导管相关性血流感染 病原菌 分布 耐药性 

分 类 号：R459.5[医药卫生—治疗学]