ICU中心静脉导管相关血行感染病原菌及耐药性分析  

Distribution and antibiotic resistance of pathogens isolated from central venous catheter-related bloodstream infections in intensive care unit

作　　者：韩楠楠[1] 李刚[1] 蔡文伟[1] 沈晔[1] 

机构地区：[1]浙江省人民医院急诊科,杭州310014

出　　处：《浙江医学》2015年第19期1621-1623,1630,共4页Zhejiang Medical Journal

摘　　要：目的分析ICU中心静脉导管相关血行感染(CRBSI)病原菌及耐药性,为合理选用抗生素,制定有效防治方案提供依据。方法回顾性分析EICU近3年来中心静脉CRBSI患者的血培养、导管细菌培养及药敏检查,总结其常见病原菌分布及耐药性。结果 61例中心静脉CRBSI患者共培养出病原菌66株,其中G^-菌33株(50.0%),G^+菌27株(40.9%),真菌6株(9.1%)。常见菌株依次为凝固酶阴性葡萄球菌(22.7%),鲍曼不动杆菌(18.2%),肺炎克雷伯菌(12.1%),金黄色葡萄球菌(10.6%),肠球菌、大肠埃希菌、铜绿假单胞菌(6.1%)。G^-菌对碳青霉素类抗生素相对敏感,未发现对万古霉素耐药的金黄色葡萄球菌。结论 G^-菌已成为EICU CRBSI患者的主要致病菌,CRBSI病原菌对常见抗生素耐药性普遍偏高。Objective To analyze the distribution and antibiotic resistance of pathogens isolated from central venous catheter-related bloodstream infections （CRBSI） in intensive care unit （ICU）. Methods A retrospective analysis was performed to review the distribution and drug resistance of pathogens isolated from patients with central venous CRBSI in ICU in the last 3 years. Results Sixty six pathogen strains were isolated from 61 cases of central venous CRBSt, including 33 strains of Gram-negative bacteria （G^-） （50.0%）, 27 strains of Gram-positive bacteria （G^＋） （40.9%） and 6 strains of fungi （9.1%）. Coagulase negative Staphylococci（22.7%）, Acinetobacter baumannii（18,2%）, Klebsiella pneumonia（12.1%）, Staphylococcus aureus （10.6%）, Enterococcus, Escherichia coil, Pseudomonas aeruginosa （4 strains, 6.1%） were the common strains in CRBSI. The antibiotic resistance tests demonstrated that G^- bacillus were relatively sensitive to Penicillium carbon alkene, while vancomycin-resistant Staphylococcus aureus strains were not found. Conclusion Gram-negative strains were the predominant pathogens of central venous catheter-related bloodstream infection in EICU. The antibiotic resistance was common in CRBSI.

关 键 词：导管相关血行感染 中心静脉导管 重症监护病房 耐药性 

分 类 号：R446.5[医药卫生—诊断学]