摘要
目的探讨ICU内血流感染的病原菌分布及耐药性情况,为临床合理选用抗生素提供依据。方法回顾性分析2010年1月～2012年4月我院ICU内18 831份临床血流感染患者血培养标本,探讨常见病原菌的分布特点及耐药性。结果分离获得菌株560株,血培养标本分离率为10.81%,革兰阳性菌占61.1%,革兰阴性菌占31.1%,真菌占7.8%,居前五位的菌株依次为溶血葡萄球菌(20.0%),鲍氏不动杆菌(12.7%),表皮葡萄球菌(11.1%),肺炎克雷伯菌(6.4%),肠球菌属(8.0%)。MRSA和MRCNS的检出率分别为89.5%和97.2%,未发现万古霉素、替考拉宁耐药的金黄色葡萄球菌,肠杆菌科细菌及非发酵菌耐药现象普遍。结论革兰阳性菌是ICU内血流感染的主要病原菌,近年来真菌感染的发生率呈上升趋势,且血培养病原菌对常见抗菌药物的耐药现象普遍存在。
Objective To address the species distribution and antibiotic resistance among pathogens causing blood- stream infections in ICU, and to establish a basis for appropriate antibiotics usage. Methods The species distribution and antibiotic resistance of 18831 samples of blood culture in ICU from Jan 2010 to Apr 2012 were analyzed retro- spectively. Results A total of 560 strains were collected with separation rate of 10.81% in the study, which included Gram-positive strains （61.1%）, Gram-negativestrains （31.1%） and fungal strains （7.8%）. Of which staphylococcus haemolyticus （20%）, Acinetobacterbaumannii （ 12.7% ）, Staphylococcus epidermidis （ 11.1% ）, Klebsiellapneumoniae （6.4%）, and Enterococcus species（8.0%） were the most common ones. MRSA and MRCNS were 89.5% and 97.2%, respectively. No Staphylococcus strain was resistant to vancomycinorteicoplanin.Antibioticresistance of Enterobacteri- aceae and non-fermenting Gram-negative bacilli were significantly more common. Conclusion Gram-positive strains were the predominant pathogens in ICU bloodstream infections.Fungal infections keptincreasing, and the antibiotic re- sistancewereserious.
出处
《中国现代医生》
2013年第23期85-87,90,共4页
China Modern Doctor
基金
浙江省自然科学基金资助项目(LQ12H01002)
浙江省医药卫生平台重点资助计划(2012ZDA002)
关键词
ICU
血流染
病原菌
耐药性
ICU
Bloodstream infections
Pathogens
Antibiotic resistance
