上海交通大学学报（医学版）
上海交通大學學報（醫學版）
상해교통대학학보（의학판）
JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY(MEDICAL SCIENCE)
2010年
4期
478-481
,共4页
外科重症监护病房%病原菌%耐药性监测
外科重癥鑑護病房%病原菌%耐藥性鑑測
외과중증감호병방%병원균%내약성감측
surgical intensive care unit%pathogen%surveillance of drug resistance
目的 分析上海交通大学医学院附属新华医院外科重症监护病房(SICU)中常见病原菌分布及其耐药特征.方法 收集123例SICU患者各种病原学标本,分析常见病原菌分布情况并进行药敏监测.结果 共分离出497株病原菌,其中革兰阴性菌占58.1%,其次为革兰阳性菌(19.7%)和真菌(22.1%).真菌以白色假丝酵母菌(15.1%)为主.痰液标本的病原体分离率较高(278株),病原菌分布从高到低依次为鲍曼不动杆菌(20.5%)、铜绿假单胞菌(20.5%)、白色假丝酵母菌(15.8%)和大肠埃希菌(7.9%).鲍曼不动杆菌对头孢哌酮/舒巴坦耐药率最低(21.0%).大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)试验的阳性率分别为49.3%和40.9%,对亚胺培南高度敏感.革兰阳性菌对万古霉素和利奈唑胺敏感性最高.结论 加强SICU病原菌流行病学监测对合理使用抗菌药物,减少耐药菌株的产生有重要临床指导价值.
目的 分析上海交通大學醫學院附屬新華醫院外科重癥鑑護病房(SICU)中常見病原菌分佈及其耐藥特徵.方法 收集123例SICU患者各種病原學標本,分析常見病原菌分佈情況併進行藥敏鑑測.結果 共分離齣497株病原菌,其中革蘭陰性菌佔58.1%,其次為革蘭暘性菌(19.7%)和真菌(22.1%).真菌以白色假絲酵母菌(15.1%)為主.痰液標本的病原體分離率較高(278株),病原菌分佈從高到低依次為鮑曼不動桿菌(20.5%)、銅綠假單胞菌(20.5%)、白色假絲酵母菌(15.8%)和大腸埃希菌(7.9%).鮑曼不動桿菌對頭孢哌酮/舒巴坦耐藥率最低(21.0%).大腸埃希菌和肺炎剋雷伯菌產超廣譜β-內酰胺酶(ESBLs)試驗的暘性率分彆為49.3%和40.9%,對亞胺培南高度敏感.革蘭暘性菌對萬古黴素和利奈唑胺敏感性最高.結論 加彊SICU病原菌流行病學鑑測對閤理使用抗菌藥物,減少耐藥菌株的產生有重要臨床指導價值.
목적 분석상해교통대학의학원부속신화의원외과중증감호병방(SICU)중상견병원균분포급기내약특정.방법 수집123례SICU환자각충병원학표본,분석상견병원균분포정황병진행약민감측.결과 공분리출497주병원균,기중혁란음성균점58.1%,기차위혁란양성균(19.7%)화진균(22.1%).진균이백색가사효모균(15.1%)위주.담액표본적병원체분리솔교고(278주),병원균분포종고도저의차위포만불동간균(20.5%)、동록가단포균(20.5%)、백색가사효모균(15.8%)화대장애희균(7.9%).포만불동간균대두포고동/서파탄내약솔최저(21.0%).대장애희균화폐염극뢰백균산초엄보β-내선알매(ESBLs)시험적양성솔분별위49.3%화40.9%,대아알배남고도민감.혁란양성균대만고매소화리내서알민감성최고.결론 가강SICU병원균류행병학감측대합리사용항균약물,감소내약균주적산생유중요림상지도개치.
Objective To analyse the distribution and antibacterial resistance of pathogens in Surgical Intensive Care Unit ( SICU) of Xinhua Hospital, School of Medicine, Shanghai Jiaotong University. Methods The pathogenic specimens of 123 patients hospitalized in SICU were collected, and all the specimens were analysed for pathogen distribution and resistance to antibiotics. Results A total of 497 strains of pathogenic bacteria were isolated, and Gram-negative bacteria were the most popular pathogens (58. 1%), whereas Gram-positive bacteria and fungi accounted for 19.7% and 22. 1%, respectively. The most common fungus was Candida albicans (15. 1%). Most pathogens were separated from lower respiratory tract (278 strains). The four most common pathogens in all the specimens were Acinetobacter baumannii (20.5%), Pseudomonas aeruginosa (20.5%), Candida albicans (15.8%) and Escherichia Coli (7.9%). Acinetobacter baumannii showed the lowest resistance to cefoperazone-sulbactam (21.0%). The positive rates of the extended spectrum β-lactamases (ESBLs)-producing strains of Escherichia coli and Klebsiella pneumoniae were 49. 3% and 40. 9%, and there was high sensitivity to imipenem. Cram-positive bacteria were most sensitive to vancomycin and linezolid. Conclusion Epidemiological investigation of pathogens in SICU is of great importance to the rational use of antibiotics and may help to reduce the emergence of resistant strains.
