CAJ | 학술논문

目的了解加强治疗病房(ICU)人工气道病人呼吸道感染的病原菌分布特征与细菌耐药情况.方法对我院2007年1月至12月ICU人工气道病人痰标本所有细菌分离株及其耐药进行回顾性分析.结果细菌总数507株,革兰阴性杆菌81.5%,革兰阳性球菌13%,真菌5.5%;革兰阳性菌中,耐甲氧西林金黄色葡萄球菌(MRSA)占金黄色葡萄球菌的89.7%,耐甲氧西林凝固酶阴性葡萄球菌(MRCN)占凝固酶阴性葡萄球菌100%;革兰阴性菌分离株仍占多数,对第三代头孢菌素耐药率较高,其中鲍曼不动杆菌所占比例明显增加,达到38.9%.万古霉素对MRSA、MRCN及肠球菌属的敏感率均为100%.结论 ICU人工气道病人下呼吸道感染以革兰阴性菌感染为主,且鲍曼不动杆菌所占比例明显增加;细菌耐药率较前明显升高.应加强ICU细菌耐药监测,了解细菌分布及耐药变化,指导临床合理用药,防止耐药菌株的传播.
목적 료해가강치료병방(ICU)인공기도병인호흡도감염적병원균분포특정여세균내약정황.방법 대아원2007년1월지12월ICU인공기도병인담표본소유세균분리주급기내약진행회고성분석.결과 세균총수507주,혁란음성간균81.5%,혁란양성구균13%,진균5.5%;혁란양성균중,내갑양서림금황색포도구균(MRSA)점금황색포도구균적89.7%,내갑양서림응고매음성포도구균(MRCN)점응고매음성포도구균100%;혁란음성균분리주잉점다수,대제삼대두포균소내약솔교고,기중포만불동간균소점비례명현증가,체도38.9%.만고매소대MRSA、MRCN급장구균속적민감솔균위100%.결론 ICU인공기도병인하호흡도감염이혁란음성균감염위주,차포만불동간균소점비례명현증가;세균내약솔교전명현승고.응가강ICU세균내약감측,료해세균분포급내약변화,지도림상합리용약,방지내약균주적전파.
Objective To study the pathogen distribution and bacterial resistence of clinical isolates from acquired respiratory tract infection of patients with artifieial airway in a genera] intensive care unit (ICU). Methods Retrospectively analyzed all the bacterial I-solates from the phlegm of patients after trachentomy and endotracbeal intubetion in the ICU of our hospital from January 2007 to De-cember 2007. Results Among all the bacterial isolates(n=507) ,the percentage of Gram- negative bacilli, Gram-positives and fungi were 81.5% ,13% ,and 5.5% ,respectively. MeticiUin resistant staphylococcus anreus and metieillin resistant coagulase negative staph-ylococcus counted for 89.7% and 100% of Gram-positive pathogens,respectively. Gram-negative bacilli account for most of the iso-lates and exhibit a high resistance to 3rd generation eephalosperins. The percentage of acinetobaeter baumanii was obviously elevated and accounted for 38.9%. The suscepfive rate of metieillin-resistant S. Aureus, metieillin resistant eoagulase negative staphylococcus and enterocoocus to vancomyein was all 100%. Conclusion The Gram-negative bacilli became primary pathogens of lower respiratory tract infection of patients after tracheotomy and endotracheal intubation in ICU and the percentage of aeinetobacter baumanii is obvious-ly elevated. Most pathogens show significant resistance to the most conmmonly used antibiotics. Monitoring of drug resistance to bacteri-urn in 1CU should be strengthened, bacterial distribution and the changes of drug resistance should be investigated in order to direct ra-tional drug usage in the clinic and prevent bacterial strains of drug resistance from being transmitted.