基层医院重症监护病房感染的病原菌分布及耐药性分析  

THE DISTRIBUTION OF PATHOGENIC BACTERIA AND DRUG RESISTANCE ANALYSIS OF ICU INFECTION IN PRIMARY HOSPITAL

作　　者：冯永 崔刘福[2] 赵辉[3] 杨文浩[2] 李晓岚[4] 赵天祺 左一红[6] Bai Qiujiang 

机构地区：[1]开滦赵各庄医院药剂科,河北省唐山市063101 [2]开滦总医院风湿科 [3]唐山市传染病医院药剂科 [4]开滦总医院重症医学科 [5]唐山市妇幼保健院生殖遗传科 [6]开滦总医院质控办

出　　处：《中国煤炭工业医学杂志》2017年第11期1340-1343,共4页Chinese Journal of Coal Industry Medicine

基　　金：河北省卫计委医学教学研究课题计划(编号:20170237)

摘　　要：目的观察基层医院重症监护病房住院患者感染病原菌特点及其耐药情况。方法选择基层医院ICU住院的496例的病原资料,观察其感染率、病原菌分布及耐药性。结果基层医院ICU医院感染发生率为20.97%,以脑卒中30.80%)和多发伤(18.95%)为主,下呼吸道感染(31.73%)和泌尿系统感染(27.88%)居高。医院感染病原菌以革兰阴性菌(61.90%)为主,革兰阳性菌(30.95%)偏低。革兰阴性菌以大肠埃希菌(16.67%)最多,其次依次为铜绿假单胞菌、克雷伯菌属、鲍曼不动杆菌、阴沟肠杆菌。药敏试验显示革兰阴性菌对含酶抑制剂类的亚胺培南耐药率低,而头孢呋辛、头孢他啶、头孢曲松等耐药率高。革兰阳性菌主要以金黄色葡萄球菌(16.07%)为主,其次为溶血性链球菌、肠球菌等。药敏试验显示革兰阳性菌对万古霉素、替考拉宁、利奈唑胺敏感,未发现对万古霉素、替考拉宁、利奈唑胺耐药菌株。结论降低院内感染发生率必须加强医院感染相关因素的控制和预防。Objective To observe the features of pathogenic bacteria infection in intensive care unit m a bastc hospital and its drug resistance.Methods The pathogenic data of 496 cases of a primary hospital inpatients with ICU,to observe the infection rate, distribution and drug resistance of pathogenic bacteria.Results The infection rate of ICU in the primary hospital was 20.97%,in which,the higher were 30.80 % with stroke and multiple injuries （18.95%）, infection of lower respiratory tract infection （31.73 %） and urinary tract （27. 88 % ）.Pathogen of nosocomial infection with Gram negative bacteria was 61.90% ,gram positive bacteria was 30.95 %.Gram negative bacteria were Eseherichia colt （16.67 % ） as the most, followed by Pseudomonas aeruginosa, Klebsiella, Bauman Acinetobacter, Enterobacter cloacae.Drug sensitivity test showed that gram negative bacteria and low rate of imipenem resistant enzyme inhibitors, and cefuroxime sodium, ceftazidime, ceftriaxone resistant rate. Gram positive bacteria were mainly Staphylococcus aureus （16.07%）, followed by hemolytic streptococcus,Enterococcus etc.Drug sensitivity test showed that gram positive bacteria were sensitive to vancomycin, linezolid,Ti Koa Laing, was not found to vancomycin, linezolid resistant strains, Ti Koa Laing.Conclusion To reduce the incidence of the primary hospital,we must strengthen the control and prevention of infection related factors of hospital infection in hospital.

关 键 词：基层医院 重症监护病房 病原菌 耐药性 

分 类 号：R197.3[医药卫生—卫生事业管理]