中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
3期
9-12,15
,共5页
内感染%病原菌%药物敏感性%急诊重症监护病房
內感染%病原菌%藥物敏感性%急診重癥鑑護病房
내감염%병원균%약물민감성%급진중증감호병방
Nosocomial infection%Pathogens%Drug resistance%Emergency Intensive Care Unit
目的：了解本院近18个月急诊重症监护病房(EICU)和非EICU患者院内感染病原体的分布差异及药敏差异。方法对急诊住院病房院内感染患者进行回顾性统计分析。结果 EICU调查例数为402例，医院感染发病率为23.88%；非EICU病房调查例数为1925例，医院感染发病率为5.30%。EICU分离出菌株259株，革兰氏阴性菌占73.36%，革兰氏阳性菌占15.06%，真菌占11.58%；非EICU分离出菌株193株，革兰氏阴性菌占65.28%，革兰氏阳性菌占21.76%，真菌占12.95%。 EICU居前三位的病原菌分别为鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌；非EICU居前三位的病原菌分别为肺炎克雷伯菌、鲍曼不动杆菌、屎肠球菌。药敏显示，肺炎克雷伯菌对碳青霉烯类高度敏感，对喹诺酮类敏感率跃70%；鲍曼不动杆菌对替加环素、头孢哌酮舒巴坦、阿米卡星的敏感率跃70%。结论 EICU较非EICU有较高院感率；非EICU与EICU患者院内感染均以革兰氏阴性菌感染为主；鲍曼不动杆菌、肺炎克雷伯菌对大多数抗菌药物耐药。
目的：瞭解本院近18箇月急診重癥鑑護病房(EICU)和非EICU患者院內感染病原體的分佈差異及藥敏差異。方法對急診住院病房院內感染患者進行迴顧性統計分析。結果 EICU調查例數為402例，醫院感染髮病率為23.88%；非EICU病房調查例數為1925例，醫院感染髮病率為5.30%。EICU分離齣菌株259株，革蘭氏陰性菌佔73.36%，革蘭氏暘性菌佔15.06%，真菌佔11.58%；非EICU分離齣菌株193株，革蘭氏陰性菌佔65.28%，革蘭氏暘性菌佔21.76%，真菌佔12.95%。 EICU居前三位的病原菌分彆為鮑曼不動桿菌、肺炎剋雷伯菌、銅綠假單胞菌；非EICU居前三位的病原菌分彆為肺炎剋雷伯菌、鮑曼不動桿菌、屎腸毬菌。藥敏顯示，肺炎剋雷伯菌對碳青黴烯類高度敏感，對喹諾酮類敏感率躍70%；鮑曼不動桿菌對替加環素、頭孢哌酮舒巴坦、阿米卡星的敏感率躍70%。結論 EICU較非EICU有較高院感率；非EICU與EICU患者院內感染均以革蘭氏陰性菌感染為主；鮑曼不動桿菌、肺炎剋雷伯菌對大多數抗菌藥物耐藥。
목적：료해본원근18개월급진중증감호병방(EICU)화비EICU환자원내감염병원체적분포차이급약민차이。방법대급진주원병방원내감염환자진행회고성통계분석。결과 EICU조사례수위402례，의원감염발병솔위23.88%；비EICU병방조사례수위1925례，의원감염발병솔위5.30%。EICU분리출균주259주，혁란씨음성균점73.36%，혁란씨양성균점15.06%，진균점11.58%；비EICU분리출균주193주，혁란씨음성균점65.28%，혁란씨양성균점21.76%，진균점12.95%。 EICU거전삼위적병원균분별위포만불동간균、폐염극뢰백균、동록가단포균；비EICU거전삼위적병원균분별위폐염극뢰백균、포만불동간균、시장구균。약민현시，폐염극뢰백균대탄청매희류고도민감，대규낙동류민감솔약70%；포만불동간균대체가배소、두포고동서파탄、아미잡성적민감솔약70%。결론 EICU교비EICU유교고원감솔；비EICU여EICU환자원내감염균이혁란씨음성균감염위주；포만불동간균、폐염극뢰백균대대다수항균약물내약。
Objective To investigate the pathogen distribution and drug resistance of nosocomial infection between Emergency Intensive Care Unit (EICU)and general ward in recent 18 months. Methods Patients with nosocomial infec-tion in EICU and general ward of our hospital were retrospectively analyzed. Results A total of 96 patients developed nosocomial infection in 402 patients came from EICU with the rate of infection was 23.88%.A total of 198 patients de-veloped nosocomial infection in 1925 patients came from the general ward with the rate of infection was 5.30%.A total of 193 strains in general ward and 259 strains in EICU were separated,the proportion of Gram negative bacteria,Gram positive bacteria and fungi was 73.36%,15.06% and 11.58% in EICU respectively.In general ward,the proportion of Gram negative bacteria,Gram positive bacteria and fungi was 65.28%,21.76% and 12.95% respectively.Among 259 strains of pathogenic bacteria in EICU,the top 3 was Acinetobacter baumannii,Klebsiella pneumonia and Pseudomonas aeruginosa respectively,and in general ward,the top 3 was Klebsiella pneumonia,Acinetobacter baumannii,Enterococcus faecom respectively.Drug sensitivity result showed,Klebsiella pneumoniae had a higher sensitivity rate of carbapenems and to quinolone sensitive rate more than 70%.Acinetobacter baumannii had higher sensitive rate of igecyline,cefopera-zone/sulbactum and amikacin,the sensitive rates more than 70%. Conclusion EICU have a higher nosocomial infection rate than general ward.The Gram positive bacteria are the preddominant pathogens causing nosocomial infection both in the EICU and the emergency general ward.Acinetobacter baumannii,Klebsiella pneumoniae are resistant to most of the commonly used antibiotics.
