摘要
目的了解中医院重症监护病房(ICU)患者医院感染常见病原菌的分布及抗菌药物敏感性,为临床医师合理使用抗菌药物提供参考依据。方法细菌培养鉴定按照《全国临床检验操作规程》,采用常规方法进行;药敏试验采用CLSI推荐的K-B法,结果判断依据CLSI 2010-2011年标准进行,并制定医院感染预防控制措施。结果分离出常见病原菌459株,以革兰阴性杆菌为主,占70.6%,其中铜绿假单胞菌、鲍氏不动杆菌、大肠埃希菌和肺炎克雷伯菌分离率最高,分别占25.1%、14.8%、10.5%和9.6%;革兰阳性球菌次之,占21.4%,其中分离率最高的为金黄色葡萄球菌、凝固酶阴性葡萄球菌和粪肠球菌,分别占8.9%、5.5%和3.9%;真菌占8.0%,主要为白色假丝酵母菌占6.3%;多数病原菌呈严重耐药和多药耐药,铜绿假单胞菌、鲍氏不动杆菌对碳青霉烯类亚胺培南、美罗培南已产生了22.6%～30.9%的耐药率;革兰阳性球菌对糖肽类抗菌药物100.0%敏感。结论中医院ICU医院感染病原菌的耐药性已十分严重,应重视ICU病原菌耐药性监测,制定预防控制措施,以指导临床医师合理用药。
OBJECTIVE To understand flora distribution and drug susceptibility of common pathogenic bacteria causing nosocomial infections in intensive care unit（ICU） in traditional Chinese medical hospital so as to guide the reasonable use of antibiotics.METHODS Referring to National Guide to Clincial Laboratory Operation Procedure,bacterial cultivation was performed by the routine methods.The drug susceptibility testing was performed by K-B method recommended by CLSI.The results were assessed according to CLSI 2010-2011 breakpoints.The strategies of prevention of nosocomial infections were instituted.RESULTS Among 459 strains of common pathogenic bacteria isolated,the majorities were gram-negative bacilli（70.6%） including Pseudomonas aeruginosa（25.1%）,Acinetobacter baumannii（14.8%）,Escherichia coli（10.5%）,and Klebsiella pneumoniae（9.6%）.Then gram-positive cocci accounted for 21.4%,including Staphylococcus aureus（8.9%）,coagulase-negative Staphylococcus（5.5%） and Enterococcus faecalis（3.9%）.Fungi accounted for 8.0%,among which Candida mycoderma was the most predominant species（6.3%）.The drug susceptibility testing indicated that the majority of the isolated pathogens were seriously drug resistant and multidrug-resistant,the drug resistance rate of Pseudomonas aeruginosa,and Acinetobacter baumannii to imipenem and meropenem varied between 22.6% and 30.9%,and the gram-positive cocci were 100.0% sensitive to glycopeptides antibiotics.CONCLUSION The pathogens causing nosocomial infections in ICU of traditional Chinese medical hospital have become seriously drug resistant,it is necessary to attach great importance to the monitoring of drug resistance of the pathogens in ICU and to set down the prevention and control measures so as to guide the reasonable use of antibiotics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第4期928-930,共3页
Chinese Journal of Nosocomiology
关键词
中医院
重症监护病房
医院感染
病原菌
药敏试验
Traditional Chinese medical hospital
Intensive care unit
Nosocomial infection
Pathogenic bacteria
Drug susceptibility testing
