佛山市中医院重症医学科痰液病原菌分布及耐药性分析  

Analysis on the distribution and drug resistance of sputum pathogens in the intensive care unit of Foshan Hospital of Traditional Chinese Medicine

作　　者：张小玲 吴英[1] 雷蕾[1] 李瑶 陈家钖[1] ZHANG Xiaoling;WU Ying;LEI Lei;LI Yao;CHEN Jiayang(Laboratory Medicine Center,Foshan Hospital of Traditional Chinese Medicine,Guangdong,Foshan 528000,China)

机构地区：[1]广东省佛山市中医院检验医学中心,广东佛山528000

出　　处：《中国医药科学》2021年第8期138-141,148,共5页China Medicine And Pharmacy

摘　　要：目的了解佛山市中医院重症医学科(ICU)近3年痰液标本的病原菌分布情况及对抗菌药物的耐药性,为指导临床合理用药提供参考依据。方法选取2017年1月1日至2019年10月17日佛山市中医院ICU合格痰液标本分离的病原菌与药敏进行回顾性调查分析。结果共分离出748株病原菌,其中革兰阴性菌579株,占77.41%,主要以鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌为主;革兰阳性菌113株,占15.11%,主要为金黄色葡萄球菌、肺炎链球菌;酵母样真菌56株,占7.48%,主要以白假丝酵母菌为主。鲍曼不动杆菌对大多数抗菌药物的耐药率大于70.00%,其中对美罗培南、亚胺培南耐药率高达91.26%、93.20%;铜绿假单胞菌对多粘菌素B高度敏感,对美罗培南、亚胺培南的耐药率分别为36.41%、39.81%;肺炎克雷伯菌对亚胺培南耐药率为9.33%,对多粘菌素B高度敏感;大肠埃希菌对美罗培南、亚胺培南的耐药率均为0.00%;金黄色葡萄球菌对苯唑西林耐药率为35.48%,未发现耐万古霉素及利奈唑胺的金黄色葡萄球菌;白假丝酵母菌对酮康唑、5-氟胞嘧啶的耐药率均为3.23%,对其他监测抗菌药物均高度敏感。结论佛山市中医院ICU痰液标本感染病原菌以革兰阴性菌为主,不同细菌的耐药率有所不同,特别是鲍曼不动杆菌、铜绿假单胞菌对碳青霉烯类抗菌药物呈现高耐药性,临床必须合理使用抗菌药物。Objective To investigate the distribution and drug resistance to antibiotics of sputum pathogens in the intensive care unit(ICU)of Foshan Hospital of Traditional Chinese Medicine in recent 3 years,so as to provide reference for guiding clinical rational medication.Methods The pathogens and drug sensitivity isolated from qualified sputum samples selected in the ICU of Foshan Hospital of Traditional Chinese Medicine from January 1,2017 to October 17,2019 were retrospectively investigated and analyzed.Results A total of 748 strains of pathogens were isolated,of which 579 strains were gram-negative bacteria,accounting for 77.41%.They were mainly Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae and Escherichia coli.There were 113 strains of grampositive bacteria,accounting for 15.11%,mainly Staphylococcus aureus and Streptococcus pneumoniae.There were 56 strains of yeast-like fungi,accounting for 7.48%,which was mainly Candida albicans.The drug resistance rate to antibiotics of Acinetobacter baumannii to most antibacterial drugs was more than 70.00%,among which the drug resistance rates to meropenem and imipenem were as high as 91.26%and 93.20%,respectively.Pseudomonas aeruginosa was highly sensitive to polymyxin B,and the drug resistance rates to meropenem and imipenem were 36.41%and 39.81%,respectively.The resistance rate of Klebsiella pneumoniae to imipenem was 9.33%,and it was highly sensitive to polymyxin B.The drug resistance rates of Escherichia coli to meropenem and imipenem were both 0.00%.The resistance rate of Staphylococcus aureus to oxacillin was 35.48%,and Staphylococcus aureus resistant to vancomycin and linezolid was not found.The resistance rate of Candida albicans to ketoconazole and flucytosine was both 3.23%,and it was highly sensitive to other monitored antibiotics.Conclusion Gram-negative bacteria are the main pathogens of sputum infection in ICU of Foshan Hospital of Traditional Chinese Medicine,and the drug resistance rates of different bacteria are different,especially Acin

关 键 词：重症医学科 痰液 病原菌 抗菌药物 耐药性分析 

分 类 号：R446.5[医药卫生—诊断学]