成都地区ICU肿瘤危重症患者呼吸机相关感染的病原菌分布及耐药性监测  

Distribution and drug resistance of pathogenic bacteria of ventilator associated infection in ICU patients with severe tumor in Chengdu area

作　　者：卢松[1] 刘真君[1] 董伟[1] 赵倩[1] LU Song;LIU Zhenjun;DONG Wei;ZHAO Qian(Department of Intensive Care Unit,Sichuan Tumor Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省肿瘤医院重症医学科,成都610041

出　　处：《国际检验医学杂志》2018年第12期1476-1478,共3页International Journal of Laboratory Medicine

基　　金：四川省卫计委科研项目(130295)

摘　　要：目的探讨成都地区重症监护病房(ICU)肿瘤危重症患者呼吸机相关感染的病原菌分布及耐药性监测。方法选自成都地区2013年1月至2016年12月ICU收治的行机械通气治疗的肿瘤危急重症患者846例。采集呼吸机相关感染患者84例痰液标本,分离培养细菌,进行细菌鉴定,采用GN201法进行革兰阴性菌药敏试验,采用GP法进行革兰阳性菌药敏试验,药敏试验采用纸片扩散法。结果 84例呼吸机相关感染患者痰液标本中培养病原菌80株,其中革兰阴性菌54株(占67.50%),革兰阳性菌21株(占26.25%),真菌5株(占6.25%)。主要革兰阴性菌对头孢他啶和头孢吡肟耐药率较高,其中铜绿假单胞菌对头孢他啶和头孢吡肟耐药率分别为94.74%、89.47%,肺炎克雷伯菌对头孢他啶和头孢吡肟耐药率分别为87.50%、93.75%,鲍曼不动杆菌对头孢他啶和头孢吡肟耐药率分别为100.00%、83.33%;主要革兰阳性菌对青霉素和红霉素耐药率较高,其中金黄色葡萄球菌对青霉素和红霉素耐药率分别为80.00%、90.00%,溶血葡萄球菌对青霉素和红霉素耐药率分别为87.50%、75.00%。结论成都地区ICU肿瘤危急重症患者呼吸机相关感染的病原菌以革兰阴性菌为主,应引起重视,并针对相关因素采取有效地监测、预防措施。Objective To investigate the distribution and drug resistance of pathogenic bacteria associated with ventilator associated infection in Intensive Care Unit（ICU）patients with severe tumor in Chengdu area.Methods 846 patients with severe and critical tumors who underwent mechanical ventilation in ICU from January 2013 to December 2016 in Chengdu area were enrolled in the study.84 sputum specimens from patients with ventilator associated infection were collected,bacteria were isolated and identified,Gram-negative bacteria drug sensitivity test was carried out by GN201 method,Gram-positive bacteria drug sensitivity test was carried out by GP method,and drug sensitivity test was carried out by paper diffusion method.Results There were 80 strains of pathogenic bacteria in the sputum specimens from 84 patients with infection related infection,including 54 Gram-negative bacteria（67.50%）,21 Gram-positive bacteria（26.25%）,and 5 fungi（6.25%）.The resistance rates of major Gram-negative bacteria to ceftazidime and cefepime were higher,and the resistance rates of Pseudomonas aeruginosato ceftazidime and cefepime were 94.74% and 89.47%,respectively,the resistance rates of Klebsiella pneumoniae to ceftazidime and cefepime were 87.50% and 93.75%,respectively,and the resistance rates of Acinetobacter Baumanto ceftazidime and cefimidime were 100.00% and 83.33%,respectively;the resistance rates of the main Gram-positive bacteria to penicillin and erythromycin were higher,and the resistance rates of Staphylococcus aureus to penicillin and erythromycin were 80.00%and 90.00%respectively,the resistance rates of Staphylococcus hemolytic to penicillin and erythromycin were 87.50%and75.00% respectively.Conclusion The pathogenic bacteria of ventilator associated infection in ICU patients with severe tumor in Chengdu area were mainly Gram-negative bacteria,which should be paid attention to,and effective monitoring and prevention measures should be taken for the relevant factors.

关 键 词：肿瘤 危重症 呼吸机相关感染 病原菌 耐药性 重症监护病房 

分 类 号：R446.5[医药卫生—诊断学]