中国医药导报
中國醫藥導報
중국의약도보
China Medical Herald
2015年
26期
162-165
,共4页
董咪娜%王峰%田雨%郭利明
董咪娜%王峰%田雨%郭利明
동미나%왕봉%전우%곽리명
ICU患者%下呼吸道院内感染%细菌种类%耐药性
ICU患者%下呼吸道院內感染%細菌種類%耐藥性
ICU환자%하호흡도원내감염%세균충류%내약성
ICU patients%Lower respiratory tract nosocomial infection%Bacterial species%Drug resistance
目的：研究ICU患者下呼吸道院内感染的细菌种类及其耐药性，为ICU患者下呼吸道院内感染的诊断与治疗提供依据。方法选择2014年1~12月入住成都医学院第一附属医院ICU且发生下呼吸道院内感染的患者148例，采集其痰液标本，进行细菌分离鉴定与药敏实验，统计并分析其下呼吸道院内感染的细菌种类及其耐药性。结果所有148例下呼吸道院内感染患者痰标本经实验室培养鉴定，检出病原菌185株，其中，真菌15株(8.11%)，细菌170株(91.89%)。革兰阴性菌141株(82.94%)，革兰阳性菌29株(17.06%)。在所有检出的病原菌中，位居前3位的革兰阴性菌依次为肺炎克雷伯菌(28.82%)、铜绿假单胞菌(18.24%)、嗜麦芽窄食单胞菌(9.92%)。检出革兰阳性菌中金黄色葡萄球菌数量最多，约为所有检出革兰阳性菌的79.31%。革兰阴性菌、革兰阳性菌对于抗生素多具有耐药性，且多数菌株为多重耐药菌株。结论及时检测ICU下呼吸道院内感染的细菌种类，动态监测细菌耐药情况，按照患者感染细菌种类以及药物敏感情况进行积极有效的治疗，能够促进患者转归，改善患者生命质量。
目的：研究ICU患者下呼吸道院內感染的細菌種類及其耐藥性，為ICU患者下呼吸道院內感染的診斷與治療提供依據。方法選擇2014年1~12月入住成都醫學院第一附屬醫院ICU且髮生下呼吸道院內感染的患者148例，採集其痰液標本，進行細菌分離鑒定與藥敏實驗，統計併分析其下呼吸道院內感染的細菌種類及其耐藥性。結果所有148例下呼吸道院內感染患者痰標本經實驗室培養鑒定，檢齣病原菌185株，其中，真菌15株(8.11%)，細菌170株(91.89%)。革蘭陰性菌141株(82.94%)，革蘭暘性菌29株(17.06%)。在所有檢齣的病原菌中，位居前3位的革蘭陰性菌依次為肺炎剋雷伯菌(28.82%)、銅綠假單胞菌(18.24%)、嗜麥芽窄食單胞菌(9.92%)。檢齣革蘭暘性菌中金黃色葡萄毬菌數量最多，約為所有檢齣革蘭暘性菌的79.31%。革蘭陰性菌、革蘭暘性菌對于抗生素多具有耐藥性，且多數菌株為多重耐藥菌株。結論及時檢測ICU下呼吸道院內感染的細菌種類，動態鑑測細菌耐藥情況，按照患者感染細菌種類以及藥物敏感情況進行積極有效的治療，能夠促進患者轉歸，改善患者生命質量。
목적：연구ICU환자하호흡도원내감염적세균충류급기내약성，위ICU환자하호흡도원내감염적진단여치료제공의거。방법선택2014년1~12월입주성도의학원제일부속의원ICU차발생하호흡도원내감염적환자148례，채집기담액표본，진행세균분리감정여약민실험，통계병분석기하호흡도원내감염적세균충류급기내약성。결과소유148례하호흡도원내감염환자담표본경실험실배양감정，검출병원균185주，기중，진균15주(8.11%)，세균170주(91.89%)。혁란음성균141주(82.94%)，혁란양성균29주(17.06%)。재소유검출적병원균중，위거전3위적혁란음성균의차위폐염극뢰백균(28.82%)、동록가단포균(18.24%)、기맥아착식단포균(9.92%)。검출혁란양성균중금황색포도구균수량최다，약위소유검출혁란양성균적79.31%。혁란음성균、혁란양성균대우항생소다구유내약성，차다수균주위다중내약균주。결론급시검측ICU하호흡도원내감염적세균충류，동태감측세균내약정황，안조환자감염세균충류이급약물민감정황진행적겁유효적치료，능구촉진환자전귀，개선환자생명질량。
Objective To study the bacteria species and drug resistance of lower respiratory tract nosocomial infection in ICU patients and provide the basis for the diagnosis and treatment for the ICU patients with lower respiratory tract nosocomial infection. Methods 148 ICU patients with lower respiratory tract nosocomial infection in Department of Critical Care Medicine, the First Affiliated Hospital of Chengdu Medical College from January to December 2014 were selected and collected the sputum samples for separating and identifying the bacteria and drug sensitive to analyze the bacteria species and drug resistance of lower respiratory tract nosocomial infection. Results 185 strains of pathogens were detected from 148 cases of sputum samples with lower respiratory tract nosocomial infection by laboratory cultiva-tion and identification. Among the detected strains, there were 15 strains of fungus strains (8.11%), 170 strains of bac-teria (91.89%); 141 strains of gram-negative bacteria (82.94%) and 29 strains of gram-positive bacteria (17.06%). The top three of detected gram-negative bacteria were Klebsiella pneumoniae (28.82%), Pseudomonas aeruginosa (18.24%), and Stenotrophomonas maltophilia (9.92%). The count of Staphylococcus aureus (79.31%) was the largest pathogens in the detected gram-positive bacteria. Most of gram-negative bacteria and gram-positive bacteria were resistant to an-tibiotics, and most of strains were multi-drug resistant. Conclusion Detecting bacterial species of the ICU patients with lower respiratory tract nosocomial infection timely, monitoring bacterial resistance dynamically and treating the patients based on bacteria species of infected and drug sensitive effectively, can promote the patient outcomes and improve the quality of life.
