中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
4期
367-371
,共5页
重症监护病房%下呼吸道感染%病原菌%耐药性
重癥鑑護病房%下呼吸道感染%病原菌%耐藥性
중증감호병방%하호흡도감염%병원균%내약성
Intensive care unit%Lower respiratory tract infection%Pathogens%Drug resistance
目的 了解重症监护病房(ICU)患者下呼吸道感染的临床特点和病原菌分布及耐药情况,为临床合理使用抗菌药物提供依据.方法 对2008年1月至2010年8月我院ICU发生下呼吸道感染患者的临床资料进行回顾性分析,对分离出的病原菌进行菌株鉴定,药敏试验采用琼脂扩散(K-B)法,结果依据CLSI(2007)标准判读.结果 ICU共收治患者509例,发生下呼吸道感染147例,下呼吸道感染发生率为28.9%(147/509);分离出病原菌283株,其中主要为G-杆菌占86.9%,其他病原菌包括G+球菌(7.4)%和真菌(5.7)%;最常见的病原菌依次为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、嗜麦芽寡养单胞菌、真菌、大肠埃希菌、金黄色葡萄球菌、洋葱伯克霍尔德菌等,分别占24.7%、20.5%、12.7%、6.4%、5.7%、5.3%、5.3%、4.6%;主要病原菌对多种抗菌药物耐药严重.结论 ICU下呼吸道感染的发生率高,G-杆菌是导致下呼吸道感染的主要病原菌,且对抗菌药物呈多重耐药.
目的 瞭解重癥鑑護病房(ICU)患者下呼吸道感染的臨床特點和病原菌分佈及耐藥情況,為臨床閤理使用抗菌藥物提供依據.方法 對2008年1月至2010年8月我院ICU髮生下呼吸道感染患者的臨床資料進行迴顧性分析,對分離齣的病原菌進行菌株鑒定,藥敏試驗採用瓊脂擴散(K-B)法,結果依據CLSI(2007)標準判讀.結果 ICU共收治患者509例,髮生下呼吸道感染147例,下呼吸道感染髮生率為28.9%(147/509);分離齣病原菌283株,其中主要為G-桿菌佔86.9%,其他病原菌包括G+毬菌(7.4)%和真菌(5.7)%;最常見的病原菌依次為鮑曼不動桿菌、銅綠假單胞菌、肺炎剋雷伯菌、嗜麥芽寡養單胞菌、真菌、大腸埃希菌、金黃色葡萄毬菌、洋蔥伯剋霍爾德菌等,分彆佔24.7%、20.5%、12.7%、6.4%、5.7%、5.3%、5.3%、4.6%;主要病原菌對多種抗菌藥物耐藥嚴重.結論 ICU下呼吸道感染的髮生率高,G-桿菌是導緻下呼吸道感染的主要病原菌,且對抗菌藥物呈多重耐藥.
목적 료해중증감호병방(ICU)환자하호흡도감염적림상특점화병원균분포급내약정황,위림상합리사용항균약물제공의거.방법 대2008년1월지2010년8월아원ICU발생하호흡도감염환자적림상자료진행회고성분석,대분리출적병원균진행균주감정,약민시험채용경지확산(K-B)법,결과의거CLSI(2007)표준판독.결과 ICU공수치환자509례,발생하호흡도감염147례,하호흡도감염발생솔위28.9%(147/509);분리출병원균283주,기중주요위G-간균점86.9%,기타병원균포괄G+구균(7.4)%화진균(5.7)%;최상견적병원균의차위포만불동간균、동록가단포균、폐염극뢰백균、기맥아과양단포균、진균、대장애희균、금황색포도구균、양총백극곽이덕균등,분별점24.7%、20.5%、12.7%、6.4%、5.7%、5.3%、5.3%、4.6%;주요병원균대다충항균약물내약엄중.결론 ICU하호흡도감염적발생솔고,G-간균시도치하호흡도감염적주요병원균,차대항균약물정다중내약.
Objective To understand the clinical characteristics of lower respiratory tract infection,pathogenic distribution and drug resistance in intensive care unit to provide a basis for reasonable use of antibiotics. Methods From January 2008 to August 2010,the clinical data from our hospital ICU impatients of lower respiratory tract infection were retrospectively analyzed. The isolated strains were identified, the antibiotic susceptibility test was performed by K-B methods and the results were read according to CLSI 2007. Results There were 509 patients, 147 cases of lower respiratory tract infection were found. Lower respiratory tract infection rate was 28.9% (147/509); 283 strains of pathogens had been isolated by culture and most of which were Gram negative bacilli(86. 9%), the other pathogens included Gram positive cocci(7.4%) and fungi(5.7%). The most common pathogens were Acinetobacter spp, Pseudomonas aeruginosa, Klebsiella pneumoniae,Stenotrophomonas oligotrophic aeromons, Fungi, Escherichia coli, Staphylococcus aureus, Burkholderia cepacia,etc,accounting for 24. 7% ,20. 5% ,12. 7% ,6. 4% ,5.7% ,5. 3% ,5.3% and 4. 6% ;The main pathogens were highly resistant to the most antibiotics. Conclusion ICU had a higher lower respiratory tract infection rate, Gram negative bacilli are the main pathogen, and showed the multi-drug resistance features to the antibiotics.
