重症监护病人呼吸道革兰阴性杆菌体外药敏监测  

Antimicrobial susceptibility test on G^- bacilli in the respiratory tract in ICU patients

作　　者：崔维韵[1] 赵群莉[1] 李红[1] 李奇志[1] 

机构地区：[1]天津铁路中心医院检验科,300140

出　　处：《河北医药》2004年第5期405-406,共2页Hebei Medical Journal

摘　　要：目的　观察分析重症病人呼吸道感染革兰阴性杆菌的耐药性 ,为急危重症病人合理使用抗生素提供依据。方法　采用K B法对重症病人呼吸道标本的 43 3株菌进行药敏试验 ,用双纸片法表型确证实验测定超广谱 β 内酰胺酶 ,采用三相提取试验测定Ⅰ类酶 (AmpC)酶。 结果　 43 3株菌中肠杆菌 186株 ,亚胺培南耐药率为 0 ,阿米卡星耐药率为 5 .9%;非发酵菌 2 47株 ,亚胺培南耐药率为 3 3 .3 %,阿米卡星耐药率为 2 2 .3 %;产酶株与非产酶株耐药结果有差异。结论　重症病人分离的菌株耐药性增强 ,同时产酶株增多 ;抗生素的效用依菌种不同有很大差异 ,确定细菌是否产酶 。Objective To provide scientific basis for properly using antibiotics on severe patient by observing and analyzing the medicine of G - bacilli in the respiratory tract in ICU patients.Methods K B method was used to make external drug sensitvity test for 433 samples of bacteria taken from ICU patients,and double taps confirming experiment was performed to test ESBLs.Results There were 186 strains of intestine bacilli among the 433 samples.The drug resistance rates to imipenem and amicacin were 0% and 5.9% respectively;There were 247 non fermentative bacteria among the samples.The drug resistances to imipenem and amikacin were 33.3% and 22.3% respectively.The drug resistance of enzyme producible bacteria was different from those bacteria which were not enzyme producible.Conclusion The drug resistance of the bacteria taken from severe patients increases,and more and more enzyme producible bacteria appear in severe patients.The effects of antibiotics will be different for different types of bacteria.It is an important principle for clinical drug application to confirm whether the bacteria produce enzyme or not.

关 键 词：重症监护病房 革兰阴性杆菌 耐药性 药敏试验 超广谱Β-内酰胺酶 AMPC酶 

分 类 号：R378.99[医药卫生—病原生物学]