急诊重症监护病房革兰阴性杆菌感染分布及耐药性  

Resistance Analysis and Infection Distribution of Gram-negative Bacilli in EICU

作　　者：经晓杰[1] 陈正辉[2] 王应忠[3] 杨秋萍[4] 韩雁冰[5] 马晓波[2] 

机构地区：[1]昆明医科大学第一附属医院医务部,云南昆明650032 [2]昆明医科大学第一附属医院检验科,云南昆明650032 [3]昆明医科大学第一附属医院急诊科,云南昆明650032 [4]昆明医科大学第一附属医院干疗科,云南昆明650032 [5]昆明医科大学第一附属医院神经内科,云南昆明650032

出　　处：《昆明医科大学学报》2015年第5期69-73,共5页Journal of Kunming Medical University

基　　金：云南省科技厅院校联合专项基金资助项目(2013FZ270)

摘　　要：目的了解2011年1月至2013年12月急诊重症监护病房(EICU)分离革兰阴性杆菌的临床分布及耐药性,为临床治疗提供参考.方法对2011年1月至2013年12月EICU住院患者各类标本中检出的942株革兰阴性杆菌感染分布、耐药性进行了回顾性分析,革兰阴性杆菌分离培养鉴定和药敏试验严格按操作规程进行.统计分析采用WHONET 5.5软件进行处理.结果 EICU临床标本中共检出革兰阴性杆菌942株,其中排名前三位的为鲍曼不动杆菌、肺炎克雷伯菌和大肠埃希菌,鲍曼不动杆菌的检出率呈逐年上升趋势,鲍曼不动杆菌对多数抗生素的耐药率高达90%;肺炎克雷伯菌对碳青霉烯类抗生素耐药率明显上升.结论 EICU检出的鲍曼不动杆菌对常用抗生素的耐药性总体呈逐年上升趋势,其明显高于其他革兰阴性杆菌,耐药现状严峻.应严格执行卫计委《抗菌药物临床应用管理办法》,将鲍曼不动杆菌列入医院监控的重点菌株中,实行医院细菌耐药的预警公示制度,防止多重耐药和泛耐药菌株在科室内的传播,从而控制细菌耐药性的上升.Objective To analyze the Gram-negative bacilli＇s distribution and antibiotic resistance status in EICU from 2011 to 2013, and provide a referrence for clinical treatment. Methods We collected Gram-negative bacilli in EICU inpatients＇ specimens from 2011 to 2013, for the retrospective analysis of infection distribution and resistance. Bacterial culture, identification and drug sensitivity tests were all according to Standard Operating Procedures. The data were analyzed by WHONETS.5. Statistics software. Results In the recent 3 years, 942 strains of Gram-negative bacilli were detected in EICU, the top three were Acinetobacter banmannii, Klebsiella pneumoniae and Escherichia coll. The detection rate of Acinetobacter baumannii increased year by year. Acinetobacter baumannii＇s resistance rate to most antibiotics was up to 90%. Klebsiella pneumoniae＇s resistance rate to Carbapenems increased significantly. Conclusions Acinetobacter baumannii＇s resistance rate to commonly used antibiotics is increasing year by year and significantly higher than other Gram-negative bacilli in EICU. The resistance status is severe. We should strictly carry out Methods clinical application of antibacterial drug management by National Health and Family Planning Commission of the People＇s Republic of China, and included Acinetobacter baumannii in the key strains of hospital monitoring, perform early warning and publicity of resistance, to prevent the spread of multi-resistant and pan-resistant strains and control the resistance rate.

关 键 词：重症监护病房 革兰阴性杆菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]