中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2015年
23期
14-16
,共3页
重症加强治疗病房%细菌分布%耐药性
重癥加彊治療病房%細菌分佈%耐藥性
중증가강치료병방%세균분포%내약성
ICU%Bacteria distribution%Drug resistance
目的：了解成都市中西医结合医院重症加强治疗病房细菌分布及耐药情况，为临床合理使用抗菌药物提供参考。方法回顾性分析成都市中西医结合医院重症医学科2011年1月—2014年1月送检标本所分离的细菌及其耐药性。结果共分离细菌632株，其中革兰阴性菌479株(75.8%)，革兰阳性菌株153株(24.2%)。革兰氏阴性菌排名前5的分别为铜绿假单胞菌103株(16.3%)、鲍曼不动杆菌100株(15.8%)、肺炎克雷伯菌85株(13.4%)、大肠肠埃希菌72株(11.4%)、阴沟肠杆菌43株(6.8%)，革兰氏阳性菌排名前3位的分别为金黄色葡萄球菌68株(10.8%)，表皮葡萄球菌37株(5.9%)，溶血葡萄球菌24株(3.8%)。鲍曼不动杆菌和铜绿假单胞菌多为多重耐药菌株，对亚胺培南耐药率分别为82.3%和52.4%。大肠埃希菌对三代头孢菌素、头孢吡肟、氨曲南及喹诺酮类的耐药率均>70.0%。耐甲氧西林金黄色葡萄球菌、表皮葡萄球菌和溶血葡萄球菌的检出率分别为88.5%、98.4%和98.2%，尚未检出对万古霉素及利奈唑胺耐药的葡萄球菌属。结论革兰阴性菌为该院重症加强治疗病房主要致病细菌，耐甲氧西林葡萄球菌呈增多趋势。细菌耐药情况较为严重且呈现多重耐药趋势，应采取积极有效措施予以防控。
目的：瞭解成都市中西醫結閤醫院重癥加彊治療病房細菌分佈及耐藥情況，為臨床閤理使用抗菌藥物提供參攷。方法迴顧性分析成都市中西醫結閤醫院重癥醫學科2011年1月—2014年1月送檢標本所分離的細菌及其耐藥性。結果共分離細菌632株，其中革蘭陰性菌479株(75.8%)，革蘭暘性菌株153株(24.2%)。革蘭氏陰性菌排名前5的分彆為銅綠假單胞菌103株(16.3%)、鮑曼不動桿菌100株(15.8%)、肺炎剋雷伯菌85株(13.4%)、大腸腸埃希菌72株(11.4%)、陰溝腸桿菌43株(6.8%)，革蘭氏暘性菌排名前3位的分彆為金黃色葡萄毬菌68株(10.8%)，錶皮葡萄毬菌37株(5.9%)，溶血葡萄毬菌24株(3.8%)。鮑曼不動桿菌和銅綠假單胞菌多為多重耐藥菌株，對亞胺培南耐藥率分彆為82.3%和52.4%。大腸埃希菌對三代頭孢菌素、頭孢吡肟、氨麯南及喹諾酮類的耐藥率均>70.0%。耐甲氧西林金黃色葡萄毬菌、錶皮葡萄毬菌和溶血葡萄毬菌的檢齣率分彆為88.5%、98.4%和98.2%，尚未檢齣對萬古黴素及利奈唑胺耐藥的葡萄毬菌屬。結論革蘭陰性菌為該院重癥加彊治療病房主要緻病細菌，耐甲氧西林葡萄毬菌呈增多趨勢。細菌耐藥情況較為嚴重且呈現多重耐藥趨勢，應採取積極有效措施予以防控。
목적：료해성도시중서의결합의원중증가강치료병방세균분포급내약정황，위림상합리사용항균약물제공삼고。방법회고성분석성도시중서의결합의원중증의학과2011년1월—2014년1월송검표본소분리적세균급기내약성。결과공분리세균632주，기중혁란음성균479주(75.8%)，혁란양성균주153주(24.2%)。혁란씨음성균배명전5적분별위동록가단포균103주(16.3%)、포만불동간균100주(15.8%)、폐염극뢰백균85주(13.4%)、대장장애희균72주(11.4%)、음구장간균43주(6.8%)，혁란씨양성균배명전3위적분별위금황색포도구균68주(10.8%)，표피포도구균37주(5.9%)，용혈포도구균24주(3.8%)。포만불동간균화동록가단포균다위다중내약균주，대아알배남내약솔분별위82.3%화52.4%。대장애희균대삼대두포균소、두포필우、안곡남급규낙동류적내약솔균>70.0%。내갑양서림금황색포도구균、표피포도구균화용혈포도구균적검출솔분별위88.5%、98.4%화98.2%，상미검출대만고매소급리내서알내약적포도구균속。결론혁란음성균위해원중증가강치료병방주요치병세균，내갑양서림포도구균정증다추세。세균내약정황교위엄중차정현다중내약추세，응채취적겁유효조시여이방공。
Objective To determine the bacteria distribution and drug resistance in the ICU of Chengdu Integrated TCM&Western Medicine Hospital so as to provide reference for clinical appropriate use of antibacterials. Methods A retrospective analysis was conducted on the distribution and drug resistance of bacteria isolated from the specimens of ICU of Chengdu Integrated TCM&Western Medicine Hospital from January 2011 to January 2014. Results A total of 632 strains of bacteria were isolated in the survey period, which included 479(75.8%) gram-negative strains, 153(24.2%) gram-positive strains. Pseudomonas aeruginosa (103 strains, 16.3%), Acinetobacter baumannii(100 strains, 15.8%), Klebsiella pneumoniae(85 strains, 13.4%), E. coli(72 strains, 11.4%) and Enterobacter cloacae (43 strains, 6.8%) were the five most common gram-negative strains. Staphylococcus aureus (68 strains, 10.8%), Staphylococcus epidermidis (37 strains, 5.9%) and Staphylococcus haemolyticus (24 strains, 3.8%) were the three most common gram-positive strains. The most of Acinetobacter baumannii and Pseudomonas aeruginosa were multiple drug-resis-tant strains, the drug resistance rates to Imipenem were 82.3%and 52.4%. The drug resistance rates of E. Coli to the third genera-tion cephalosporin, cefepime, aztreonam and quinolones fluoroquinolones were above 70.0%. The methicillin-resistant detection rate of Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus haemolyticus was 88.5%, 98.4% and 98.2%, re-spectively. No Staphylococcus strain was resistant to vancomycin and linezolid. Conclusion Gram-negative strains were the pre-dominant bacteria in the ICU of Chengdu Integrated TCM&Western Medicine Hospital, the methicillin-resistant Staphylococcus aureus showed a trend of increase. More positive and effective measures should be taken to control and prevent the worsening drug resistance and multidrug resistance of the bacteria.
