重症监护室患者感染常见病原菌分布及耐药性分析  

Distribution of pathogens causing infection in ICU and drug resistance analysis

作　　者：张秀芳[1] 王小扁[1] 李峰[2] 柴杰[1] 谭雪峰[1] 

机构地区：[1]安徽省亳州市人民医院检验科,236800 [2]安徽省蚌埠医学院第一附属医院检验科,233004

出　　处：《中华全科医学》2015年第4期634-635,669,共3页Chinese Journal of General Practice

摘　　要：目的分析重症监护室(ICU)患者感染常见病原菌的分布及耐药情况,为临床合理使用抗菌药物提供依据。方法对2013年全年ICU送检的各种标本的细菌学培养结果进行回顾性分析。结果共检出病原菌805株。其中革兰氏阴性杆菌705株(占87.6%),革兰氏阳性球菌100株(占12.4%)。而革兰氏阴性杆菌中鲍曼不动杆菌检出211株(占26.2%),且多为泛耐药菌株,其次分别为肺炎克雷伯菌183株(占22.7%)、铜绿假单胞菌122株(占15.2%)、大肠埃希氏菌90株(占11.2%)、阴沟肠杆菌34株(占4.2%)、嗜麦芽窄食单胞菌30株(占3.7%)、洋葱伯克霍尔德菌28株(占3.5%),均对头孢类抗菌药物耐药率较高,对亚胺培南、哌拉西林/他唑巴坦耐药率较低;革兰氏阳性球菌中主要为葡萄球菌属,对万古霉素、利奈唑烷、喹努普汀/达福普汀、替加环素均敏感。结论 ICU患者感染严重,病原菌以革兰氏阴性杆菌为主,其次是革兰氏阳性球菌。呈现细菌种类多、耐药率高的特点。应加强ICU感染病原菌分布及耐药性监测,合理规范使用抗菌药物,避免耐药菌在医院传播及流行。Objective To investigate the distribution of pathogens causing infection and drug resistance, and provide basis for the rational use of antimicrobials. Methods The outcome of bacterial culture from the ICU submitted specimens in 2013 was analyzed retrospectively. Results Total 805 strains of pathogenic bacteria were detected, including 705 strains of gram-negative bacilli（87.6% ） and 100 strains of gram-positive cocci（ 12.4% ）. There were 211 strains of Acineto- bacter baumannii（26.2% ） which were most pan-resistant strains in the detected gram-negative bacilli;others were 183 strains of klebsiella pneumoniae （ 22.7 % ）, 122 strains of pseudomonas aeruginosa （ 22.7 % ）, 90 strains of Escherichia coli（ 11.2% ）,34 strains of Enterobacter cloacae （4.2%）, 30 strains of Stenotrophomonas maltophilia （3.7%） and 28 strains of Burkhol cepacia（ 3.5% ） , all of them were with a higher Antibiotics resistance rate and a lower resistance rate to imipenem ,and piperacllin/tazobactam. Staphylococci were the main bacteria in the detected gram-positive cocci, which were sensitive to vancomycin, linezolid and quinupristin/dalfopristin and tigecycline. Conclusion The infection in ICU often lead to a serious medical condition. The gram-negative bacilli are the main pathogens causing infection, gram-positive cocci next. The pathogens causing the infection often including many types of bacteria with a higher drug resistance rate, the identification and drug sensitivity test for ICU bacterial infection should be strengthened. The antibiotics should be used rationally to prevent the spread of resistant bacteria in hospitals.

关 键 词：重症监护室 病原菌分布 耐药性 

分 类 号：R378[医药卫生—病原生物学] R446.5[医药卫生—基础医学]