中华医院感染学杂志
中華醫院感染學雜誌
중화의원감염학잡지
Chinese Journal of Nosocomiology
2015年
9期
1959-1961
,共3页
鲍氏不动杆菌%重症监护病房%病原学检测
鮑氏不動桿菌%重癥鑑護病房%病原學檢測
포씨불동간균%중증감호병방%병원학검측
Acinetobacter baumannii%Intensive care unit%Etiological test
目的：探讨IC U感染的病原菌分布及其耐药性，以指导临床合理用药。方法选取2010年5月－2013年10月IC U 收治的529例患者，对患者的痰液、尿液、胸腹腔积液等标本进行病原菌培养、鉴定，药敏试验采用K‐B琼脂扩散法，采用SPSS13．0软件对数据进行统计分析。结果共检出病原菌371株，其中革兰阳性菌82株占22．11％，革兰阴性菌232株占62．53％，真菌57株占15．36％；主要革兰阴性菌对常用抗菌药物的耐药率普遍较高，鲍氏不动杆菌对妥布霉素、阿米卡星敏感，耐药率＜10．00％，铜绿假单胞菌对妥布霉素、美罗培南敏感，对阿米卡星100．00％敏感，肺炎克雷伯菌对头孢哌酮／舒巴坦、亚胺培南、美罗培南100．00％敏感；鲍氏不动杆菌对三代头孢的耐药率高达100．00％，对环丙沙星、头孢吡肟的耐药率＞90．00％，对美罗培南和亚胺培南的耐药率已＞80．00％。结论 IC U病原菌感染主要分布在呼吸道，以革兰阴性菌为主，其中鲍氏不动杆菌的感染率逐年上升，并呈现泛耐药性，临床诊疗中应加强抗菌药物的合理使用和鲍氏不动杆菌的耐药性检测。
目的：探討IC U感染的病原菌分佈及其耐藥性，以指導臨床閤理用藥。方法選取2010年5月－2013年10月IC U 收治的529例患者，對患者的痰液、尿液、胸腹腔積液等標本進行病原菌培養、鑒定，藥敏試驗採用K‐B瓊脂擴散法，採用SPSS13．0軟件對數據進行統計分析。結果共檢齣病原菌371株，其中革蘭暘性菌82株佔22．11％，革蘭陰性菌232株佔62．53％，真菌57株佔15．36％；主要革蘭陰性菌對常用抗菌藥物的耐藥率普遍較高，鮑氏不動桿菌對妥佈黴素、阿米卡星敏感，耐藥率＜10．00％，銅綠假單胞菌對妥佈黴素、美囉培南敏感，對阿米卡星100．00％敏感，肺炎剋雷伯菌對頭孢哌酮／舒巴坦、亞胺培南、美囉培南100．00％敏感；鮑氏不動桿菌對三代頭孢的耐藥率高達100．00％，對環丙沙星、頭孢吡肟的耐藥率＞90．00％，對美囉培南和亞胺培南的耐藥率已＞80．00％。結論 IC U病原菌感染主要分佈在呼吸道，以革蘭陰性菌為主，其中鮑氏不動桿菌的感染率逐年上升，併呈現汎耐藥性，臨床診療中應加彊抗菌藥物的閤理使用和鮑氏不動桿菌的耐藥性檢測。
목적：탐토IC U감염적병원균분포급기내약성，이지도림상합리용약。방법선취2010년5월－2013년10월IC U 수치적529례환자，대환자적담액、뇨액、흉복강적액등표본진행병원균배양、감정，약민시험채용K‐B경지확산법，채용SPSS13．0연건대수거진행통계분석。결과공검출병원균371주，기중혁란양성균82주점22．11％，혁란음성균232주점62．53％，진균57주점15．36％；주요혁란음성균대상용항균약물적내약솔보편교고，포씨불동간균대타포매소、아미잡성민감，내약솔＜10．00％，동록가단포균대타포매소、미라배남민감，대아미잡성100．00％민감，폐염극뢰백균대두포고동／서파탄、아알배남、미라배남100．00％민감；포씨불동간균대삼대두포적내약솔고체100．00％，대배병사성、두포필우적내약솔＞90．00％，대미라배남화아알배남적내약솔이＞80．00％。결론 IC U병원균감염주요분포재호흡도，이혁란음성균위주，기중포씨불동간균적감염솔축년상승，병정현범내약성，림상진료중응가강항균약물적합리사용화포씨불동간균적내약성검측。
OBJECTIVE To investigate the distribution and drug resistance of the pathogens causing infections in the ICU patients so as to guide the reasonable clinical use of antibiotics .METHODS A total of 529 patients who were treated in the ICUs from May 2010 to Oct 2013 were enrolled in the study ,then the sputum ,urine ,and thoracic and abdominal effusions specimens were collected for the culture of pathogens ,the cultured pathogens were identi‐fied ,the drug susceptibility testing was performed by using K‐B agar diffusion method ,and the statistical analysis was carried out with the use of SPSS13 .0 software .RESULTS Totally 371 strains of pathogens have been isolated , including 82 (22 .11% ) strains of gram‐positive bacteria ,232 (62 .53% ) strains of gram‐negative bacteria ,and 57 (15 .36% ) strains of fungi .The main gram‐negative bacteria were highly resistant to the commonly used antibiot‐ics ;the drug resistance rates of the Acinetobacter baumannii to tobramycin and amikacin were less than 10 .00% ;the Pseudomonas aeruginosa was susceptible to tobramycin and meropenem ,with the drug susceptibility rate of 100 .00% to amikacin;the drug susceptibility rates of the K lebsiella pneumoniae to cefoperazone‐sulbactam ,imi‐penem ,and meropenem were 100 .00% ;the drug resistance rate of the A .baumannii to the third generation ceph‐alosporins was as high as 100 .00% , the drug resistance rates to ciprofloxacin and cefepime were more than 90 .00% ,and the drug resistance rates to meropenem and imipenem were more than 80 .00% .CONCLUSION The respiratory tract infections dominate the infections in the ICU patients that are caused by the pathogens ,the gram‐negative bacteria are the predominant pathogens ,the incidence of A .baumannii infection is increased year by year , and it shows pandrug‐resistant .It is necessary for the hospital to strengthen the reasonable use of antibiotics and the drug resistance testing of the A .baumannii .
