重症监护病房脓毒症孕产妇的病原学检查及耐药性分析  

Etiological examination and drug resistance analysis of pregnant women with sepsis in ICU

作　　者：杜晓红 谢海波 柴韩飞 DU Xiao-hong;XIE Hai-bo;CHAI Han-fei(Zhoushan Women's and Children's Hospital,Department of Critical Care Medicine,Zhoushan,Zhejiang 316000,China)

机构地区：[1]舟山市妇女儿童医院重症医学科,浙江舟山316000

出　　处：《中国妇幼保健》2023年第22期4313-4316,共4页Maternal and Child Health Care of China

基　　金：浙江省舟山市科技计划项目(2021C31095)。

摘　　要：目的探讨重症监护病房(ICU)脓毒症孕产妇的病原学检查及耐药性。方法回顾性分析2018年12月—2022年12月在舟山市妇女儿童医院ICU进行治疗的脓毒症孕产妇165例临床资料,分别对所有研究对象的病原学分布及耐药情况进行分析。结果ICU脓毒症孕产妇中,革兰氏阳性菌的检出率为69.70%,革兰氏阴性菌的检出率为30.30%,在革兰氏阳性菌中,检出率从高到低依次为粪肠球菌(20.00%)、咽峡炎链球(14.55%)、无乳链球菌(10.95%)、草绿色链球菌(9.70%)、金黄色葡萄球菌(8.48%)及屎肠球菌(6.06%),而在革兰氏阴性菌中,检出率从高到低依次为肠杆菌(24.24%)、肺炎克雷伯菌(3.64%)及摩氏摩根氏菌(2.42%)。通过对革兰氏阳性菌的耐药情况进行分析,其中以利福平(85.22%)、环丙沙星(36.52%)及左氧氟沙星(24.35)的耐药情况较为严重,通过对革兰氏阴性菌的耐药情况进行分析,其中以庆大霉素(68.00%)、左氧氟沙星(44.00%)的耐药情况较为严重。结论ICU脓毒症孕产妇的病原学主要以革兰氏阳性菌为主,建议针对患者的耐药结果,及时进行有针对性的抗生素治疗。Objective To study the etiological examination and drug resistance of pregnant women with sepsis in intensive care unit(ICU).Methods In this retrospective study,165 cases of maternal sepsis patients treated in ICU of our hospital from December 2018 to December 2022 were selected as research objects,and the etiological distribution and drug resistance of all subjects were analyzed respectively.Results In pregnant women with sepsis in ICU,the detection rate of gram-positive bacteria was 69.70%,and the detection rate of Gram-negative bacteria was 30.30%.The detection rates from high to low were enterococcus faecalis(20.00%),Streptococcus pharyngitis(14.55%),Streptococcus agalactis(10.95%),Streptococcus virescens(9.70%),Staphylococcus aureus(8.48%)and Enterococcus faecium(6.06%).The detection rate from high to low was enterobacter(24.24%),Klebsiella pneumoniae(3.64%),and Morganella morgani(2.42%).Through the analysis of the drug resistance of Gram-positive bacteria,the drug resistance of Elifampin(85.22%),ciprofloxacin(36.52%),levofloxacin(24.35)was more serious.Through the analysis of the drug resistance of Gram-negative bacteria,Among them,gentamicin(68.00%)and levofloxacin(44.00%)were more resistant.Conclusion The pathogenology of pregnant women with sepsis in ICU is mainly gram-positive bacteria.It is suggested to carry out timely and targeted antibiotic treatment according to the drug resistance results of patients.

关 键 词：脓毒症 重症监护病房 病原学 耐药 抗生素 

分 类 号：R714[医药卫生—妇产科学]