ICU多重耐药菌定植感染的病原菌、药敏性分析  

Analysis of pathogenic bacteria and drug sensitivity of multi drug resistant bacteria in ICU

作　　者：马迪[1] 费东生[1] MA Di;FEI Dongsheng(Department of Intensive Care Unit,the First Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院ICU,黑龙江哈尔滨150001

出　　处：《国际检验医学杂志》2020年第11期1337-1340,共4页International Journal of Laboratory Medicine

基　　金：黑龙江省卫生厅科研课题基金项目(2013019)。

摘　　要：目的探讨重症监护室(ICU)多重耐药性致病菌定植感染的病原菌、药敏性,并分析其相关危险因素。方法选取2017年3月至2019年7月在该院ICU进行治疗的患者190例,从痰液、尿液、血液等体液中提取检测标本,进行细菌培养,之后进行病原菌的鉴别和药敏试验,并通过收集其一般资料,进行危险因素分析。结果金黄色葡萄球菌对妥布霉素、复方磺胺甲噁唑、呋喃妥因等耐药率较低;肺炎克雷伯菌对阿米卡星、头孢他啶的耐药率较低;鲍曼不动杆菌对氨曲南、他唑巴坦及复方磺胺甲噁唑的耐药率较低;经Logistic分析,使用第3代头孢菌类药物、抗菌药物使用种类(>两种)、抗菌药物使用时间(≥3 d)及ICU住院时间(≥7 d)为ICU多重药敏性致病菌定植感染的危险因素(OR>1,P<0.05)。结论ICU多重耐药性致病菌定植感染以革兰阴性菌为主,且ICU住院时间、抗菌药物使用时间、抗菌药物种类等为其发生的危险因素,故需采取有效干预措施。Objective To explore the pathogenic bacteria and drug sensitivity of multi drug resistant pathogens colonization in ICU,and analyze the related risk factors.Methods A total of 190 patients who were treated in ICU from March 2017 to July 2019 were selected.The samples were collected from sputum,urine,blood and other body fluids for bacterial culture,and then the identification of pathogenic bacteria and drug sensitivity test were carried out.Results Staphylococcus aureus had a low resistance rate to tobramycin,compound neonomine,Furofen,etc.Klebsiella pneumoniae had a low resistance rate to amikacin and ceftazidime.Acinetobacter baumannii had a low resistance rate to aztreonam,tazobactam and compound sinomine.Based on Logistic analysis,the use of the third generation of cephalosporins,the types of antibacterials(>2),the duration of antibacterials(≥3 d),and the length of stay in the ICU(≥7 d)were the risk factors of multiple drug-sensitive pathogens in ICU(OR>1,P<0.05).Conclusion Gram-negative bacteria are the main pathogens in ICU,and the length of stay in ICU,the time of use of antibiotics and the types of antibiotics are the risk factors of the infection,so the effective invention measures are needed.

关 键 词：多重耐药性致病菌定植感染 重症监护室 病原菌 药敏性 危险因素 

分 类 号：R446.5[医药卫生—诊断学]