摘要
目的探讨ICU与呼吸科下呼吸道感染的病原菌分布及耐药率,为临床医师合理应用抗菌药物提供依据。方法收集2011年1-12月ICU与呼吸科患者送检的痰液及灌洗液标本,采用美国Microscan Autoscan-40微生物分析仪对细菌做鉴定及药敏试验,应用WHONET5软件及SPSS12.0进行数据统计分析。结果呼吸科与ICU的病原菌构成以及耐药率有较大差异,ICU检出病原菌前3位依次为鲍氏不动杆菌、铜绿假单胞菌、大肠埃希菌,分别占27.31%、22.49%、20.48%;呼吸科检出病原菌前3位依次为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌,分别占24.66%、20.55%、16.44%;大肠埃希菌在ICU和呼吸科对常用抗菌药物的耐药率相似;肺炎克雷伯菌在ICU的耐药率明显高于呼吸科,对多数抗菌药物耐药率>30.0%,而呼吸科对常用的抗菌药物大多敏感;铜绿假单胞菌在ICU的耐药率高于呼吸科,而且出现耐亚胺培南的铜绿假单胞菌(IRPA)占17.9%,呼吸科亚胺培南对铜绿假单胞菌的耐药率为0;两科对鲍氏不动杆菌的耐药率均较高,但呼吸科稍低;在ICU的耐甲氧西林金黄色葡萄球菌(MRSA)对利福平的耐药率较呼吸科明显升高。结论 ICU和呼吸科的病原菌分布及耐药率均有所不同,临床医师除了熟悉本单位病原菌分布及耐药率监测情况外,还应掌握本科室的细菌耐药率情况,才能正确合理应用抗菌药物。
OBJECTIVE To explore the distribution and drug resistance rates of pathogens causing lower respiratory tract infections in ICU and respiratory ward so as to provide basis for the rational clinical application of antibiotics. METHODS The sputum specimens and lavage specimens that were submitted from ICU and respiratory department Jan to Dec 2011were collected.The bacterial identification and drug susceptibility testing were performed by Microscan Autoscan-40,and the data were statistically analyzed with the use of WHONET 5and SPSS12.0software. RESULTS The pathogens distribution and drug resistance ratios of ICU and respiratory ward were significantly different,the top three species of pathogens isolated from the ICU included Acinetobacter baumannii（27.31%）, Pseudomonas aeruginosa（22.49%）,and Escherichia coli（20.48%）,while the top three species of pathogens isolated from the respiratory department were E.coli（24.66%）,P.aeruginosa（20.55%）,and Klebsiella pneumonia（16.44%）.Drug resistance rates of the E.coli were similar in ICU and respiratory ward.The rates of K.pneumoniae and P.aeruginosain ICU were significantly higher than those in the respiratory ward,and the resistance rates to most drugs were more than 30.0%,while the strains isolated from the respiratory department were susceptible to most of the commonly used antibiotics.The drug resistance rate of P.aeruginosa.was higher in ICU than in the respiratory ward,and the imipenem-resistant P.aeruginosa（IRPA）were 17.9% and 0,respectively.The drug resistance rate of the A.baumannii was higher in ICU than in the respiratory ward,and the resistance rate of methicillin-resistant Staphylococcus aureus（MRSA）to rifampin was significantly higher in ICU than in the respiratory ward.CONCLUSIONThe pathogens isolated from the ICU and the respiratory ward vary in the distribution and drug resistance,it is necessary for the cilia physicians to grasp the distribution and drug resistance of the pathogens not only isolated from his own hospital but also from the his own department so as to reasonably use antibiotics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第1期50-52,共3页
Chinese Journal of Nosocomiology
基金
广西壮族自治区科学技术厅基金项目(桂科攻1140003A-43)
关键词
重症监护病房
呼吸科
下呼吸道感染
病原菌
Intensive care unit
Respiratory ward
Lower respiratory tract infection
Pathogen
