重症监护病房常见病原菌的分布及耐药性分析  

Distribution and antibiotic resistance of pathogens isolated from Intensive Care Unit

作　　者：周红岩[1,2] 郑媛媛[1] 张红岩[1] 于红[2] 

机构地区：[1]滨州市人民医院检验科,山东滨州256610 [2]青岛大学医学院医学微生物学教研室,山东青岛266071

出　　处：《中国微生态学杂志》2015年第5期588-592,共5页Chinese Journal of Microecology

摘　　要：目的了解滨州市人民医院重症监护病房(ICU)常见病原菌种类及分布,并分析其耐药性的变迁,为临床合理应用抗菌药物提供依据。方法对2011年1月1日至2013年12月31日我院ICU住院患者各类标本分离的病原菌进行培养,应用BD PhoenixTM-100全自动微生物鉴定仪鉴定细菌菌种,K-B法进行药敏试验检测,WHONET 5.6软件进行统计分析。结果 3年共收集3 449份标本,检出非重复病原菌1 802株,阳性分离率为52.25%,其中革兰阴性菌1 399株占77.64%,以鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌为主;革兰阳性菌275株占15.26%,以葡萄球菌和肠球菌为主;真菌128株占7.10%,以白色假丝酵母菌为主。主要致病革兰阴性杆菌对亚胺培南和美罗培南敏感,而对替卡西林、头孢他啶及哌拉西林均耐药;革兰阳性菌对万古霉素、替考拉宁、呋喃妥因、利奈唑胺及氯霉素敏感,而对青霉素耐药率高达100.00%。鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌的ESBLs检出率分别为81.47%、74.19%和56.26%。结论我院ICU病原菌以革兰阴性杆菌为主,对大多数常用抗生素的耐药率较高,应加强病原菌耐药性的监测,为临床医生合理应用抗菌药物提供依据。Objective To investigate the distribution and antibiotic resistance of clinical isolates from ICU inpatients so as to provide foundation for the clinical use of antibiotics. Methods Various clinical samples were collected from ICU inpatients in the People＇s Hospital of Binzhou from Jan. 2011 to Dec. 2013. The pathogenic bacteria were identified by BD PhoenixTM-100 automated microbiology system,and antimicrobial susceptibility was assessed by Kirby-Bauer disc diffusion method. The data was analyzed by WHONET 5. 6 Software. Results A total of 1802 strains of bacteria were isolated,including 1399（ 77. 64%） strains of Gram-negative bacteria,which were dominated by Acinetobacter baumannii,Pseudomonas aeruginosa and Klebsiella pneumonia,and 275（ 15. 26%）strains of Gram-positive bacteria,mainly Staphylococci and Enterococc coccus. There were 128 strains of fungi（ 7. 10%）,which was dominated by Candida albicans. Most of the Gram-negative isolates showed high sensitivity to imipenem and meropenem,but highly resistant to Ticarcillin,Ceftazidime,and Piperacillin. Gram-postive bacteria were highly sensitive to Vancomycin,Teicoplanin,Nitrofurantoin,Linezolid and Chloramphenicol,but resistant to Penicillin（ 100. 00%）. The positive rate of ESBLs producing strains of Acinetobacter baumannii,Escherichia coli and Klebsiella pneumoniae were 81. 47%,74. 19% and 56. 26%,respectively. Conclusion Most of the isolates from the ICU of our hospital are Gram-negative bacteria resistant to most antibiotics. Surveillance of antibiotic susceptibility is very important for providing basis for rational clinical use of antimicrobial agents.

关 键 词：重症监护病房 病原菌 耐药性 

分 类 号：R378.99[医药卫生—病原生物学]