小儿心外科ICU医院感染病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens for hospital infections in ICU for pediatric cardiac surgery

作　　者：孟黎辉[1] 高月[1] 熊莹[1] 王静[1] 张宏家[2] 

机构地区：[1]首都医科大学附属北京安贞医院医院感染管理办公室,北京100029 [2]首都医科大学附属北京安贞医院医院心脏外科中心,北京100029

出　　处：《中华医院感染学杂志》2015年第3期683-685,共3页Chinese Journal of Nosocomiology

基　　金：北京市自然科学基金资助项目(7112041)

摘　　要：目的了解医院小儿心外科重症监护病房感染患儿病原菌分布及耐药性,为临床合理选用抗菌药物提供依据。方法对医院2008年9月-2013年9月小儿心外科重症监护病房,医院感染患儿送检的各类标本分离出的病原菌及其耐药性进行回顾性分析,采用WHONET5.4软件对数据进行统计分析。结果共分离出病原菌116株,其中革兰阴性菌占61.20%、革兰阳性菌占31.90%、真菌占6.90%;感染病原菌主要为鲍氏不动杆菌、肺炎克雷伯菌、泛耐药不动杆菌属、表皮葡萄球菌、大肠埃希菌和铜绿假单胞菌,分别占16.38%、9.48%、9.48%、7.76%、5.17%和5.17%;鲍氏不动杆菌、肺炎克雷伯菌对头孢曲松、头孢吡肟的耐药率均>30.00%,对头孢哌酮/舒巴坦、亚胺培南耐药率约25.00%;表皮葡萄球菌对青霉素、红霉素耐药率>80.00%。结论小儿心外科重症监护病房细菌耐药形势严峻,监测感染病原菌分布及耐药性,指导合理应用抗菌药物,对降低病原菌耐药率至关重要。OBJECTIVE To investigate the distribution and drug resistance of pathogens in Pediatric Cardiac Surgery Intensive Care Unit （ICU）, so as to provide reasonable clinical application of antibiotics. METHODS The distribution and drug resistance of pathogenic bacteria isolated and identified from 116 clinical specimens in Pediatric Cardiac Surgery ICU from Sep. 2008 to Sep. 2013 were analyzed. Data were statistically analyzed by the software WHONET 5. 4. RESULTS A total of 116 pathogens strains were isolated, including gram-negative bacteria, grarn-positive baeteria and fungi accounting for 61.21%, 31.90%, and 6.9%. The most common patho- gens of them were Acinetobacter baumannii, Klebsiella pneumonia, pan-resistant Acinetobacter, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa accounting for 16.38%, 9.48%, 9.48%, 7.76%, 5.17%and 5. 17%. The resistance rate of A. baumannii and K. pneumoniae to ceftriaxone and cefepime were more than 30.00%, while to cefoperazone/sulbactarn and imipenern were about 25.00%. The resistance rate of S. epidermidis to penicillin and erythromycin were more than 80.00%. CONCLUSION As the situation of drug resistance of pathogens in Pediatric Cardiac Surgery ICU is serious, it is crucial to intensify the monitoring of pathogens and drug resistance so as to guide the reasonable use of antibiotics to reduce the bacterial resistance.

关 键 词：重症监护病房 小儿心脏外科 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]