重症监护室患者常见致病菌及其耐药性分析  

Analysis of common pathogenic bacteria and their drug resistance in intensive care unit patients

作　　者：史志娟 SHI Zhijuan(Department of Laboratory Medicine,Sixth People's Hospital of Anyang City,Anyang Henan 455000,China)

机构地区：[1]安阳市第六人民医院检验科,河南安阳455000

出　　处：《天津药学》2025年第2期229-232,共4页Tianjin Pharmacy

摘　　要：目的探讨重症监护室(ICU)患者常见致病菌及其耐药性。方法选择2022年1月至2023年12月安阳市第六人民医院收治的321例重症ICU患者,调查重症ICU患者致病菌检出情况,并分析主要致病菌及其耐药性。结果321例重症ICU患者中培养出病原菌365株,其中革兰阴性菌258株,占70.68%;革兰阳性菌85株,占23.29%;真菌22株,占6.03%。鲍曼不动杆菌对环丙沙星、左氧氟沙星、头孢噻肟、头孢他啶、头孢吡肟、头孢哌酮/舒巴坦、氨苄西林/舒巴坦、哌拉西林/他唑巴坦、替卡西林/棒酸、庆大霉素、亚胺培南、美罗培南耐药率偏高,均在50.00%以上,对米诺环素、复方新诺明耐药率偏低,分别为12.35%和34.57%;肺炎克雷伯菌耐药率较低,均在35.00%以下,对阿米卡星、亚胺培南、美罗培南耐药率只有11.11%;大肠埃希菌对环丙沙星、左氧氟沙星、复方新诺明、头孢噻肟耐药率偏高,均在50.00%以上,对阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、美罗培南耐药率偏低,均在5.00%以下;金黄色葡萄球菌对青霉素、红霉素耐药率较高,分别为94.74%和73.68%,对多西环素、替加环素、利福平、达托霉素、利奈唑胺、替考拉宁、万古霉素耐药率为0.00%;屎肠球菌对青霉素、红霉素、左氧氟沙星耐药率较高,均在85.00%以上,对替加环素、利奈唑胺、替考拉宁、万古霉素耐药率为0.00%;粪肠球菌对红霉素、四环素耐药率较高,在70.00%以上,对青霉素、替加环素、达托霉素、利奈唑胺、替考拉宁、万古霉素耐药率为0.00%。结论重症ICU患者主要致病菌为革兰阴性菌,不同致病菌耐药性不同,临床应根据菌株鉴定及药敏试验结果合理选择抗生素。Objective To explore the common pathogenic bacteria and their drug resistance in intensive care unit(ICU)patients.Methods A total of 321 critically ill ICU patients in Sixth People's Hospital of Anyang City from January 2022 to December 2023 were selected to investigate the detection of pathogenic bacteria in critically ill ICU patients and analyze the main pathogenic bacteria and their drug resistance.Results Out of 321 critically ill ICU patients,365 strains of pathogenic bacteria were cultured,including 258 strains of gram-negative bacteria,accounting for 70.68%,and 85 strains of gram-positive bacteria,accounting for 23.29%;22 fungi,accounting for 6.03%;The resistance rate of Acinetobacter baumannii to ciprofloxacin,levofloxacin,cefotaxime,ceftazidime,cefepime,cefoperazone/sulbactam,ampicillin/sulbactam,piperacillin/tazobactam,ticarcillin/clavulanic acid,gentamicin,imipenem,and meropenem is relatively high,all above 50.00%.The resistance rate to minocycline and compound sulfamethoxazole is relatively low,at 12.35%and 34.57%,respectively;The resistance rate of Klebsiella pneumoniae is relatively low,all below 35.00%,with a resistance rate of only 11.11%to amikacin,imipenem,and meropenem;The resistance rate of Escherichia coli to ciprofloxacin,levofloxacin,compound sulfamethoxazole,and cefotaxime is relatively high,all above 50.00%.The resistance rate to amikacin,cefoperazone/sulbactam,piperacillin/tazobactam,imipenem,and meropenem is relatively low,all below 5.00%;Staphylococcus aureus has a high resistance rate to penicillin and erythromycin,with rates of 94.74%and 73.68%,respectively.Its resistance rate to doxycycline,tigecycline,rifampicin,daptomycin,linezolid,teicoplanin,and vancomycin is 0.00%;Enterococcus faecium has a high resistance rate to penicillin,erythromycin,and levofloxacin,all of which are above 85.00%.Its resistance rate to tigecycline,linezolid,teicoplanin,and vancomycin is 0.00%;The resistance rate of Enterococcus faecalis to erythromycin and tetracycline is relatively high,exceeding 70.00%,w

关 键 词：重症监护病房 致病菌 耐药性 

分 类 号：R515.3[医药卫生—内科学]