急诊重症监护室细菌感染与药敏分析  

Analysis on nosocomial infection and antimicrobial susceptibility in EICU

作　　者：臧秀贤[1] 徐大海[1] 张楠[1] 逄利[1] 

机构地区：[1]吉林大学第一医院急诊科,长春130021

出　　处：《中华灾害救援医学》2015年第10期565-567,共3页Chinese Journal of Disaster Medicine

摘　　要：目的了解医院急诊重症监护室(emergency intensive care unit,EICU)病原菌分布、药物敏感及耐药情况,指导临床合理使用抗生素。方法分析笔者所在医院EICU证实有院内细菌感染的临床病例,对其进行细菌鉴定和药敏试验。结果医院细菌感染率10.5%,在85例感染患者中,痰培养阳性率85.9%,血培养阳性率14.1%,中段尿培养和中心静脉尖段培养无细菌生长。检出的病原菌中,以革兰阴性杆菌为主,其中大肠埃希菌占22.4%,鲍曼不动杆菌占21.2%,肺炎克雷白杆菌占5.9%。药敏结果显示细菌耐药性明显增强,大多数革兰阴性菌对美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星有较高敏感性;革兰阳性菌对万古霉素、利奈唑胺高度敏感。结论 EICU院内感染病原菌多为耐药菌株,应加强医院内细菌感染及耐药监测,采取有效措施减少院内感染的发生率。Objective To investigate the etiology distribution, antimicrobia/susceptibility and drug resistance in EICU, in order to provide reference for antibiotics use. Methods Clinical cases with nosocomial bacterial infections in EICU of our hospital were analyzed, and then identification and susceptibility of bacteria were detected. Results Bacterial strains were found in 85 cases from 810 patients （10.5%）. Sputum culture＇positive rate is 85.9%, blood culture positive rate is 14.1%, and midstream urine culture and central venous tip segment culture have not bacterial growth in samples of the 85 patients. Gram-negative bacilli are the primary pathogens among all bacteria detected, and the ratio of E.coli, acinetobacter baumannii and klebsiella pneumoniae were 22.4%, 21.2% and 5.9% respectively. Drug susceptibility test results showed that bacteria/resistance significantly increased. Most of gram-negative bacteria had high sensitivity to meropenem, cefoperazone/sulbactam, piperacillin/tazobactam and amikacin; and gram-positive bacteria were highly sensitive to vancomycin and linezolid.. Conclusions Nosocomia/infections in EICU are mostly resistant strains. It is important to strengthen monitoring of bacterial infection and antibiotic resistance to reduce incidence of nosocomia/infections.

关 键 词：重症监护病房 院内感染 药敏试验 

分 类 号：R378[医药卫生—病原生物学]