烧伤重症监护室病原菌分布与耐药率分析  

Analysis of Distribution and Drug Resistance of Pathogens in Burn Intensive Care Unit

作　　者：胡建明 陆娟[2] HU Jianming LU Juan(Wuxi Hospital of Traditional Chinese Medicine)

机构地区：[1]无锡市中医医院 [2]江南大学附属医院,江苏无锡214122

出　　处：《航空航天医学杂志》2023年第10期1159-1162,共4页Journal of Aerospace medicine

摘　　要：目的了解近年来烧伤重症监护室(烧伤ICU)病原菌的分布特点及对常用抗菌药物的耐药情况,为临床治疗重症烧伤感染合理用药提供依据。方法收集2020年01月-2022年12月某三甲医院烧伤重症监护室分离的病原菌。分别采用法国Bio-MerieuxVITEKMS基质辅助激光解析飞行时间质谱仪与VITEK2Compact全自动细菌鉴定药敏仪及配套试剂完成细菌鉴定及相应的药敏试验。按美国临床实验室标准化委员会(Clinical and Laboratory Standards Institute,CLSI)当年标准判读结果,应用WHONET5.6软件进行统计和分析。结果2020~2022年烧伤重症监护室送检各类标本2404份,经培养分离后鉴定出1167株病原菌,阳性率48.54%。主要病原菌为革兰阴性菌(811株,69.49%),其次是革兰阳性菌(321株,27.51%)和真菌(35株,2.99%)。构成比前4位的细菌依次为铜绿假单胞菌(25.02%)、肺炎克雷伯菌(21.17%)、金黄色葡萄球菌(18.42%)、鲍曼不动杆菌(16.45%)。其中耐甲氧西林金黄色葡萄球菌(MRSA)检出率为97.7%,对青霉素、喹诺酮类和氨基糖苷类耐药率均>90%、对红霉素耐药率稍低,未发现耐万古霉素的金黄色葡萄球菌株。肺炎克雷伯菌及铜绿假单胞菌对碳青酶烯类的耐药率在80%以上,而鲍曼不动杆菌的碳青酶烯类的耐药率高达98.4%。结论烧伤重症监护室分离病原菌耐药比率较高,应加强临床标本送检及抗菌药物的耐药监测,参考病原菌的抗生素敏感模式用药,提升烧伤ICU的抗感染效果。Objective To investigate the distribution characteristics of pathogens in burn intensive care unit and their resistance to common antibiotics in recent years,and to provide evidence for rational drug use in the clinical treatment of severe burn infection.Methods Pathogens isolated from burn intensive care unit of a Class A tertiary hospital from January 1,2020 to December 31,2022 were collected.Bio-Merieux VITEK MS matter-assisted laser time-of-flight mass spectrometer and VITEK 2 Compact automatic bacterial identification drug sensitivity instrument and supporting reagents were used to complete the bacterial identification and corresponding drug sensitivity tests.The results were interpreted according to the 2020 edition of the Clinical and Laboratory Standards Institute(CLSI),and the WHONET5.6 software was used for statistics and analysis.Results From 2020 to 2022,2404 specimens of various types were collected from the burn intensive care unit,and 1167 strains of pathogenic bacteria were identified after culture and isolation,with a positive rate of 48.54%.The main pathogenic bacteria were Gram-negative bacteria(811 strains,69.49%),fllowed by Gram-positive bacteria(321 strains,27.51%)and fungi(35 strains,2.99%).The top 4 bacteria were Pseudomonas aeruginosa(25.02%),Klebsiella pneumoniae(21.17%),Staphylococcus aureus(18.42%),and Acinetobacter baumanni(16.45%).The detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was 97.7%,and the resistance rate to penicillin,quinolones and aminoglycosides were all>90%,the resistance rate to erythromycin was slightly lower,and no vancomycin resistant staphylococcus aureus strain was found.The drug resistance rate of Klebsiella pneumoniae and Pseudomonas aeruginosa to carbapenases was more than 80%,while that of Acinetobacter baumanni was 98.4%.Conclusions The rate of drug resistance of isolated pathogens in burn intensive care unit is high,so it is necessary to strengthen clinical specimen inspection and antibiotic resistance monitoring,and refer to the antibiot

关 键 词：烧伤ICU 病原菌分布 耐药性 

分 类 号：R826.5[医药卫生—临床医学]