普通科室分离菌与ICU分离菌分布及耐药性的对比性研究  

General department isolated bacteria separated from ICU bacteria distribution and drug resistance of comparative research

作　　者：王春艳[1] 周树生[1] 曹晓光[1] 鲁怀伟[2] 戴媛媛[2] 刘宝[1] 

机构地区：[1]安徽医科大学附属省立医院ICU,合肥230001 [2]安徽医科大学附属省立医院检验科,合肥230001

出　　处：《安徽医科大学学报》2015年第3期337-341,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省教育厅自然科学研究项目(自筹)(编号:KJ2009B001Z)

摘　　要：目的了解2013年安徽医科大学附属省立医院普通科室分离菌和ICU分离菌之间细菌分布和对抗菌药物耐药性的分析研究。方法收集临床各科室送检的病原体,分离培养与鉴定,并对ICU与普通科室分离的病原体的分布及耐药性进行对比分析。对ICU临床分离菌的分布和耐药情况和普通科室分离菌进行比较性研究。结果 2013年全院共分离4 052株,其中普通科室3 068株,ICU 984株,均以杆菌为主,其中普通科室杆菌依次为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯杆菌和鲍曼不动杆菌,共占48.5%,球菌主要为金黄色葡萄球菌及肠球菌,共占13.3%。ICU杆菌依次为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌、大肠埃希菌,共占64.0%,球菌为肠球菌及金黄色葡萄球菌,共占11.2%。普通科室分离大肠埃希菌、肺炎克雷伯杆菌、铜绿假单胞菌对碳青霉烯敏感性较高,分别在90.0%、80.0%、60.0%以上,而鲍曼不动杆菌只有29.7%敏感;金黄色葡萄球菌对苯唑西林敏感率54.7%。而ICU分离的除大肠埃希菌对亚胺培南敏感性为98.5%,铜绿假单胞菌及肺炎克雷伯敏感率仅达到50.0%,鲍曼不动杆菌耐药严重,敏感率只有6.0%。球菌属对苯唑西林敏感率只有33.3%,统计后较普通科室无明显差异。结论 ICU分离菌和普通科室分离菌分布及耐药性存在明显差异,其中革兰阴性杆菌分布及耐药性较普通科室比例明显增加。故定期进行全院及ICU细菌耐药性监测,将有助了解ICU细菌的分布和耐药情况,从而指导临床合理用药。Objective To investigate the research of bacteria distribution between bacteria isolated from general de- partment and ICU and of the antibacterial drug resistance from our hospital in 2013. Methods The pathogen was collected to cultivate and identify from clinic department, and to analyse the distribution of pathogens and drug re- sistance between ICU and general department in our hospital in 2013. The isolated bacteria distribution and drug resistance in general wards were compared with the ICU. Results Partial separation of 4 052 strains from our hos- pital in 2013, of which 3 068 strains in common ward and 984 strains in ICU, were given priority to Bacillus. E. coli, Pseudomonas aeruginosa, KlebsieUa pneumoniae and Acinetobacter baumannii were successive in the com-mon ward, they accounted for 48.5%. Cocci mainly for Staphylococcus aureus and Enterococcus, accounted for 13.3%. Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumonia, E. coli and Bacillus accounted for 64. 0% in ICU, coccus of Enterococcus and Staphylococcus aureus, accounted for 11.2%. E. coli, Klebsiella pneumonia and Pseudomonas aeruginosa was separated from general wards had high sensitivity on carbon alkene, a- bove 90. 0%, 80. 0%, 60. 0% respectively, compared to 29.7% of Acinetobacter baum^mnii sensitive. Staphylo- coccus aureus separated from general wards of benzene westwood sensitive rate was 54.7%. E. coli＇s sensitivity to imipenem was 98.5%, sensitivity rate of Pseudomonas aeruginosa and Klebsiella pneumonia was 50. 0% in ICU, Acinetobacter baumannii drug resistance was serious, only 6. 0%. Acteria genera of benzene westwood sensitive rate was only 33.3%. It has obvious difference compared with general wards. Conclusion Bacteria distribution and drug resistance of bacteria between ICU and the common wards exist obvious difference, negative bacilli and the re- sistance in the common ward increased significantly compared with ICU. So bacterial drug resistance surveillance on a regular basis in ICU and the whole hospita

关 键 词：细菌 耐药性 ICU 

分 类 号：R378[医药卫生—病原生物学]