摘要
目的了解重症监护病房(ICU)下呼吸道感染的病原菌及耐药情况,为临床及ICU感染的控制提供依据。方法将ICU送检的3 087份痰标本进行培养,分离出1 028株病原菌;采用法国生物梅里埃公司全自动细菌鉴定仪进行鉴定和药敏试验。结果 1 028株病原菌中,革兰阴性杆菌784株(占76.3%),革兰阳性球菌98株(占9.5%),真菌146株(占14.2%)。革兰阴性杆菌中以铜绿假单胞菌和洋葱伯克霍尔德菌多见,均为183株(各占17.8%);革兰阳性球菌以金黄色葡萄球菌为主,检出66株(占6.4%);真菌以白色念珠菌为主,检出104株(占10.1%)。药敏试验显示,主要病原菌对临床常用抗菌药物的耐药率较高,且具多重耐药性。除嗜麦芽窄食单胞菌外,其他革兰阴性杆菌对碳青霉素烯类药物最敏感,耐药率均<18.5%,最低可至0。革兰阳性球菌对万古霉素和利奈唑烷虽具极高的活性,但对青霉素和红霉素等却有较高的耐药性。常用抗真菌药物对各种念珠菌均有较高的抗菌活性。结论 ICU获得性下呼吸道感染的病原菌多为多重耐药菌,临床应依据病原菌病原学及耐药状况,合理选择和使用抗菌药物,有效控制感染,减少新的耐药菌株出现。
Objective To investigate the condition of pathogenic bacteria in acquired respiratory infection in ICU and their drug resistance, so as to provide basis for control of the acquired infection clinically and in ICU. Methods Totally 3 087 sputum samples gained from ICU were cultured and then separated 1 028 strains of pathogenic bacteria. The bacterium identifica- tion instrument by the French BioM6rieux company was used to identify them and then to conduct the drug sensitivity. Results In the 1 028 strains of the pathogenic bacterium, 784 （76. 3% ） were gram negative bacillus, 98 （9.5%） were gram positive bacil- lus, and 146 （ 14. 2% ） were fungus. In the gram negative bacillus the most common were Pseudomonas aeruginosa and Burk- holderia cepaeia, with 183 strains for each, accounting for 17. 8%. In the gram positive bacillus, Staphylococcus anreus was the major one, with 66 strains, accounting for 6. 4%. Candida albieans was the most common pathogen, with 104 strains, ac- counting for 10. 1%. The results of drug sensitivity test showed that the main pathogenic bacteria presented high drug resistance, and usually multi -drug resistance. Gram negative bacilli, except for the Stenotrophomonas maltophilia, were most sensitive to Carbapenems, with a drug resistance rate of less than 18. 5% , or even zero. Gram positive bacilli were highly sensitive to Van- comycin and Linezolid, but had a higher resistance rate for Penicillin and Erythromycin. Fungi were of higher sensibility to the common antifungal agents. Conclusion Most pathogenic bacteria of the acquired infection in the lower respiratory tract in ICU are of multi - drug resistance. Rational use of antibiotics should be carried out according to etiology and drug resistant data of pathogenic bacteria in order to control infections effectively and reduce new drug resistant bacterium.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第16期1885-1887,共3页
Chinese General Practice
关键词
重症监护病房
获得性下呼吸道感染
病原菌
耐药性
Intensive care unit
Acquired lower respiratory tract infection
Pathogenic bacterium
Drug resistance
