2013-2014年ICU患者病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens isolated from ICU patients in 2013-2014

作　　者：康凯[1] 南川川[1] 宋宁[1] 路娟[2] 赵鸣雁[1] 

机构地区：[1]哈尔滨医科大学附属第一医院重症医学科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第一医院检验科,黑龙江哈尔滨150001

出　　处：《中华医院感染学杂志》2016年第12期2767-2769,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省卫生厅科研基金资助项目(QC2012C014)

摘　　要：目的分析医院ICU入住患者的菌群分布和耐药性,为临床治疗提供依据。方法选择2013-2014年入住医院ICU病原菌培养结果阳性患者3 688例,用BACTEC FX全自动细菌培养系统和VITEK-2Compact全自动细菌鉴定仪进行菌株鉴定及药敏分析,将病原菌的分布及药敏结果进行分析。结果 3 688例患者标本中以痰液标本最多,占53.38%;其次为血液及脓汁,分别占15.55%及5.27%;共分离出病原菌3 688株,其中革兰阴性菌占64.30%,革兰阳性球菌株占23.44%,真菌占11.27%;主要革兰阳性菌对青霉素G、红霉素、四环素的耐药率均>60.0%,鲍氏不动杆菌对头孢吡肟、亚胺培南和环丙沙星的耐药率均>90.0%。结论医院ICU患者感染病原菌仍以革兰阴性菌为主,但耐药率有上升趋势,革兰阴性菌中以鲍氏不动杆菌为主,真菌感染有下降趋势,应加强ICU主要致病菌及其耐药性监测,合理使用抗菌药物,减少医院感染及耐药菌产生。OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from hospitalized patients so as to provide guidance for the clinical treatment.METHODS A total of 3 688 patients who were hospitalized the ICU and cultured positive for pathogens from 2013 to 2014were enrolled in the study,then the pathogens were identified by using BACTEC FX automatic bacterial culture system and VITEK-2Compact automatic bacterial identification system,the drug susceptibility testing was performed,and the distribution of the pathogens and the result of the drug susceptibility testing were observed.RESULTS Of the specimens that were obtained from the 3 688 patients,53.38% were sputum specimens,15.55% were blood specimens,and 5.27% were pus specimens.Totally 3 688 strains of pathogens were isolated,of which 64.30% were gram-negative bacteria,23.44%were gram-positive cocci,and 11.27% were fungi.The drug resistance rates of the main gram-positive bacteria to penicillin G,erythromycin,and tetracycline were more than 60.0%;the drug resistance rates of the Acinetobacter baumannii to cefepime,imipenem,and ciprofloxacin were more than 90.0%.CONCLUSIONThe gram-negative bacteria remain dominant among the pathogens causing the infections in the ICU patients,however,the drug resistance rates show upward trends,especially the drug resistance rate of the A.baumannii strains which are dominant among the gramnegative bacteria;the incidence of fungal infections shows a downward trend.It is necessary to strengthen the surveillance of the main species of pathogens and their drug resistance and reasonably use antibiotics so as to reduce the incidence of nosocomial infections patients and prevent the occurrence of drug-resistant strains.

关 键 词：重症监护病房 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]