中国急救复苏与灾害医学杂志
中國急救複囌與災害醫學雜誌
중국급구복소여재해의학잡지
CHINA JOURNAL OF EMERGENCY RESUSCITATION AND DISASTER MEDICINE
2014年
2期
132-134
,共3页
ICU(重症监护病房)%病原菌%敏感率%耐药率
ICU(重癥鑑護病房)%病原菌%敏感率%耐藥率
ICU(중증감호병방)%병원균%민감솔%내약솔
ICU (Intensive care unit)%Pathogenic bacteria%Drug sensitivity%Drug resistance
目的：探讨ICU病区病原菌分布特点及药物敏感率情况，为临床合理选用抗菌药物提供参考。方法统计2012年7月~12月北京天坛医院ICU检出病原菌的种类、数量、标本来源及药敏结果等数据，并分析这一时段ICU病原菌的流行特点及药敏和耐药特点。结果ICU分离的病原菌来源主要是痰标本，占79.0%。病原菌种类革兰氏阴性菌占76.2%，革兰氏阳性菌占23.8%。常见革兰氏阴性菌前3位依次是铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌。其中鲍曼不动杆菌耐药严重，对美罗培南的敏感率只有9.8%。革兰氏阳性菌中以金黄色葡萄球菌为主，占81.6%。金黄色葡萄球菌中耐甲氧西林的金黄色葡萄球菌（MRSA）占61.3%；凝固酶阴性葡萄球菌中耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）占45.5%。结论由于ICU抗菌药物使用频率高、剂量大、时间长等原因，导致病原菌敏感率低，耐药严重。医院应加强ICU抗菌药物使用的监督和管理，避免耐药率上升。
目的：探討ICU病區病原菌分佈特點及藥物敏感率情況，為臨床閤理選用抗菌藥物提供參攷。方法統計2012年7月~12月北京天罈醫院ICU檢齣病原菌的種類、數量、標本來源及藥敏結果等數據，併分析這一時段ICU病原菌的流行特點及藥敏和耐藥特點。結果ICU分離的病原菌來源主要是痰標本，佔79.0%。病原菌種類革蘭氏陰性菌佔76.2%，革蘭氏暘性菌佔23.8%。常見革蘭氏陰性菌前3位依次是銅綠假單胞菌、肺炎剋雷伯菌、鮑曼不動桿菌。其中鮑曼不動桿菌耐藥嚴重，對美囉培南的敏感率隻有9.8%。革蘭氏暘性菌中以金黃色葡萄毬菌為主，佔81.6%。金黃色葡萄毬菌中耐甲氧西林的金黃色葡萄毬菌（MRSA）佔61.3%；凝固酶陰性葡萄毬菌中耐甲氧西林凝固酶陰性葡萄毬菌（MRCNS）佔45.5%。結論由于ICU抗菌藥物使用頻率高、劑量大、時間長等原因，導緻病原菌敏感率低，耐藥嚴重。醫院應加彊ICU抗菌藥物使用的鑑督和管理，避免耐藥率上升。
목적：탐토ICU병구병원균분포특점급약물민감솔정황，위림상합리선용항균약물제공삼고。방법통계2012년7월~12월북경천단의원ICU검출병원균적충류、수량、표본래원급약민결과등수거，병분석저일시단ICU병원균적류행특점급약민화내약특점。결과ICU분리적병원균래원주요시담표본，점79.0%。병원균충류혁란씨음성균점76.2%，혁란씨양성균점23.8%。상견혁란씨음성균전3위의차시동록가단포균、폐염극뢰백균、포만불동간균。기중포만불동간균내약엄중，대미라배남적민감솔지유9.8%。혁란씨양성균중이금황색포도구균위주，점81.6%。금황색포도구균중내갑양서림적금황색포도구균（MRSA）점61.3%；응고매음성포도구균중내갑양서림응고매음성포도구균（MRCNS）점45.5%。결론유우ICU항균약물사용빈솔고、제량대、시간장등원인，도치병원균민감솔저，내약엄중。의원응가강ICU항균약물사용적감독화관리，피면내약솔상승。
Objective To discuss explore characteristics of pathogenic bacteria distribution and antimicrobial drug sensitive rate in ICU, and provide the reference for clinical antimicrobial drug usage. Methods Data on pathogenic bacteria species, number, antibiotic susceptibility results and others collected at ICU of Beijing Tiantan Hospital in between July and December, 2012 was analyzed. Results Sources of pathogenic bacteria at the ICU were mainly separated from sputum, accounting for 79.0%. Species of pathogenic bacteria were mainly G- bacteria, accounting for 76.2%and G+bacteria account for 23.8%. The top three types of G- bacteria were pseudomonas aeruginosa, klebsiella pneumonia and acinetobacter baumannii. Drug resistance of acinetobacter baumannii reflected being serious, and the sensitive rate to meropenem was only 9.8%. The most popular G+ bacterium was mainly staphylococcus aureus, accounting for 81.6%. Among Staphylococcus aureus, methicillin-resistant staphylococcus aureus (MRSA) account for 61.3% ; among Coagulase negative staphylococcus, methicillin-resistant coagulase negative staphylococcus (MRCNS) account for 45.5%. Conclusion Due to the feature of high frequency, high dosage, and longer time of antimicrobial drug usage in ICU, it lowers the frequency of sensitivity and increases antibiotic resistance. The use of antimicrobial drugs in ICU has to be more cautious in order to avoid unnecessary drug resistance.
