ICU医院感染患者病原菌分布特点及血清PCT变化与预后临床价值分析  

Distribution of pathogens isolated from ICU patients with nosocomial infections and clinical value of serum PCT in prognosis

作　　者：陈淼[1] 林晓军[1] 张红璇[1] 方明[1] 何楷然[1] 

机构地区：[1]广东省人民医院(广东省医学科学院)急危重症医学部,广东广州510080

出　　处：《中华医院感染学杂志》2017年第13期2951-2953,2960,共4页Chinese Journal of Nosocomiology

基　　金：广东省医学科研技术基金资助项目(A20160800)

摘　　要：目的探讨ICU医院感染患者病原菌分布特点及血清降钙素原(PCT)变化与预后临床价值。方法选取医院2015年1月-2016年12月ICU感染患者98例作为观察组,另选医院同期健康体检者73例作为对照组,采集患者血液/痰液标本分离病原菌,进行细菌鉴定,其中革兰阳性菌药敏试验采用GN201法,革兰阴性菌药敏试验采用GP法,以纸片扩散法进行药敏试验;同时采集入组研究对象外周静脉血,分离血清,采用半定量固相免疫测定法测定血清PCT含量,比较两组血清PCT水平变化及死亡组和存活组血清PCT水平变化。结果 ICU感染患者98例检出病原菌107株,其中革兰阴性菌61株占57.01%,革兰阳性菌38株占35.51%,真菌8株占7.48%;主要革兰阴性菌对头孢曲松和头孢噻肟耐药率较高;主要革兰阳性菌对青霉素和红霉素耐药率较高;观察组血清PCT水平高于对照组(P<0.05);死亡患者血清PCT水平高于存活患者(P<0.05)。结论 ICU医院感染患者病原菌分布以革兰阴性菌为主,其血清PCT水平明显上升,且其水平对患者预后具有积极作用,故而具有重要临床研究价值。OBJECTIVE To explore the distribution of pathogens isolated from ICU patients with nosocomial infections and analyze the clinical value of serum procalcitonin（PCT）in prognosis.METHODS Totally 98 ICU patients with infection who were treated from Jan 2015 to Dec 2016 were assigned as the observation group,meanwhile,73 healthy people who received physical examination were set as the control group.The blood or sputum specimens were collected for culture of pathogens,the isolated pathogens were identified,the drug susceptibility testing for gram-positive bacteria was carried out by using GN201 method,the drug susceptibility testing for gram-negative bacteria was conducted by means of GP method,and the drug susceptibility testing was performed with the use of disk diffusion method.The peripheral venous blood was drawn from the enrolled study objects so as to separate serum,the serum PCT level was determined by using semi-quantitative solid-phase immunoassay,the serum PCT level was compared between the two groups,and the serum PCT level was compared between the death group and the survival group.RESULTS A total of 107 strains of pathogens were isolated from the 98 ICU patients with infection,of which 61（57.01%）were gram-negative bacteria,38（35.51%）were gram-positive bacteria,and 8（7.48%）were fungi.The major species of the gram-negative bacteria were highly resistant to ceftriaxone and cefotaxime;the major species of the gram-positive bacteria were highly resistant to penicillin and erythromycin.The serum PCT level of the observation group was higher than that of the control group（P〈0.05）;the serum PCT level of the death group was higher than that of the survival group（P〈0.05）.CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the ICU patients with nosocomial infections,the serum PCT level of the patients is remarkably elevated,it has positive role in prognosis of the patients and thus has significant clinical study value.

关 键 词：ICU感染 病原菌 降钙素原 预后 

分 类 号：R378[医药卫生—病原生物学]