摘要
目的:了解重症监护病房(ICU)下呼吸道感染病原菌流行及耐药现状的特点,为临床合理应用抗菌药物提供依据。方法:用WHONET5.3软件统计分析2004年南京医科大学第一附属医院ICU住院患者399份痰液标本培养及药敏结果,并与同期普通病房住院患者的结果进行比较。结果:ICU病原菌流行谱与普通病房有显著差异。ICU常见病原菌对各类抗生素耐药率ICU也明显高于普通病房。革兰阴性菌超广谱β-内酰胺酶(ESBLs)检出率为27.4%,耐甲氧西林葡萄球菌(MRS)占所有葡萄球菌的78.6%,对大部分抗生素出现高度耐药。结论:目前ICU下呼吸道感染病原体中条件致病菌及多重耐药菌比例逐年上升。对ICU的铜绿假单胞菌建议使用哌拉西林/他唑巴坦,产ESBLs菌株建议选用碳青霉烯类、哌拉西林/他唑巴坦,MRS推荐用万古霉素。
Objective：To investigate the distribution and antibiotic resistance of the pathogens in lower airways in intensive care units （ICU）. nethods：A total of 399 sputum strains isolated from ICU inpatients with lower airways infections during 2004 were analyzed by the software WHONET 5.3 for the drug susceptibility of pathogens. The results were compared with those from general ward inpatients. Results：The distribution of pathogen in ICU was significantly different from that in general ward. The rate of antibiotic resistance was significantly higher in ICU than that in general ward. Bacteria producing extended-spectrum beta-lactamase （ESBLs） were detected with a rate of 27.4%. MethiciUin-resistant Staphylococcus（MRS） accounted for 78.6% of all Staphylococcus, resisting significantly to Macrolides, Cephalosporins and Fluoroquinolones. Conclusion：At present, opportunistic pathogens and multidrug resistant pathogens play a more and more important role in lower airways infection. Piperacillin/tazobactam is suggested for the Pseudomonas aeruginosa from the inpatients in ICU. Carbopenems and Piperacillin/tazobactam for ESBLs-producing pathogens and Vancomycin for MRS.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2007年第4期317-321,共5页
Journal of Nanjing Medical University(Natural Sciences)
