成人ICU与非ICU病区常见细菌分布及耐药性分析  

The distribution and antibiotic resistance of clinical common bacteria in adults in ICU and non ICU ward

作　　者：韦志福[1] 郭世辉[1] 梁宏洁[1] 

机构地区：[1]广西医科大学第一附属医院,南宁530021

出　　处：《广西医科大学学报》2017年第10期1468-1471,共4页Journal of Guangxi Medical University

摘　　要：目的:分析成人重症监护病房(ICU)与非ICU患者感染病原菌的分布和耐药情况,为临床合理选用抗菌药物和控制院内感染提供依据。方法:采用VITEK 2 Compact辅以K-B纸片法对病原菌进行鉴定和药敏试验,并对比分析成人ICU与非ICU患者感染病原菌分布及耐药情况。结果:(1)从成人ICU患者标本中分离培养出病原菌2 106株,分离的主要病原菌株依次为鲍曼不动杆菌(35.5%)、铜绿假单胞菌(17.1%)、肺炎克雷伯菌(10.1%);(2)从非ICU患者标本分离培养出病原菌5 726株,主要病原菌依次为大肠埃希菌(27.1%)、铜绿假单胞菌(16.1%)、肺炎克雷伯菌(11.4%);(3)成人ICU分离的菌株耐药率普遍高于非ICU,成人ICU分离的鲍曼不动杆菌对大部分抗生素耐药率大于75%。结论:成人ICU分离菌株耐药情况严重,应加强抗菌药物合理使用及细菌耐药监测,这是控制院内感染、降低细菌耐药率的重要手段。Objective： To investigate the distribution and drug resistance of the common bacteria in adult ICU and non-ICU wards and to provide evidence for rational selection of antibacterial drugs and control of nosocomi- al infection. Methods： Using VITEK 2 Compact assisted by the K-B method, the pathogenic bacteria were iden- tified and subjected to drug susceptibility test. Comparative analysis was performed on the distribution and drug resistance of the pathogenic bacteria between patients in adult ICU and non-ICU. Results： （1）2,106 pathogenic strains were isolated from the cultures of patient specimens in adult ICU, the primary pathogenic bacteria isolat- ed from patients in adult ICU were Acinetobacter baumannii（35.5% ）, Pseudomonas aeruginosa（ 17. 1%）, and Klebsiella pneumoniae （10. 1% ） ; （2）5,726 pathogenic strains were isolated from the cultures of patient speci- mens in non-ICU, the primary pathogenic bacteria isolated from patients in non-ICU were E. coli（27. 1% ）, Pseudomonas aeruginosa（ 16. 1% ）, and K. pneumoniae（ 11.4% ） ; （3）the bacterial strains isolated from adult ICU generally had higher drug resistance rate than those from non-ICU; specifically, baumanii isolated from adult ICU had an over 75% resistance rate to most of the antibiotics. Conclusion：There is severe drug resis- tance among the bacterial strains isolated from adult ICU. It is therefore important for controlling nosocomial in- fection and lowering the bacterial drug resistance rate to strengthen the rational use of antibacterial drugs and monitoring of bacterial drug resistance.

关 键 词：ICU 病原菌 多重耐药 耐药率 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]