摘要
目的了解医院重症监护室(ICU)与非ICU主要革兰阴性(G-)杆菌的分布及耐药性,为临床合理使用抗菌药物提供依据。方法对某院2011—2013年住院患者送检标本中培养分离的G-菌标本来源及耐药性进行统计分析,比较ICU与非ICU的差异。结果 25 153份标本共分离G-菌3 875株,分离率15.41%;其中ICU1 121份标本中分离G-菌527株,分离率47.01%,非ICU24 032份标本分离G-菌3 348株,分离率13.93%,两者比较差异有统计学意义(χ2=899.32,P<0.001)。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)菌株检出率:ICU分别为56.00%(28/50)、70.65%(65/92),非ICU分别为52.81%(517/979)和40.37%(241/597)。ICU中铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌对亚胺培南的耐药率分别为36.59%、88.54%、10.00%、10.87%,均高于非ICU同类菌的耐药率,分别为20.21%、61.15%、1.74%、2.85%。结论 ICU主要G-杆菌的耐药率高于非ICU,且以多重耐药的非发酵菌为主。临床治疗应区别对待,以减少耐药菌的产生。
Objective To investigate the distribution and antimicrobial resistance of major gram-negative bacilli isolated from patients in intensive care unit （ICU） and non-ICU wards, and provide reference for rational clinical antimicrobial appli- cation. Methods Specimen sources and antimicrobial resistance of gram-negative bacilli from hospitalized patients in ICU and non-ICU wards between 2011 and 2013 were analyzed statistically and compared. Results A total of 3 875 gram-nega- tive bacterial isolates were detected among 25 153 specimens, isolation rate was 15.4l %; 1 121 specimens from ICU were isolated 527 isolates of gram-negative bacilli, isolation rate was 47.01% ; 3 348 isolates of gram-negative bacilli were isola- ted from 24 032 specimens of non-ICU, isolation rate was 13.93%, there was significant difference between the two（x2 = 899. 32, P〈0. 001 ）. Extended-spectrum β-1actamases （ESBLs）-produeing rate of Escherichia coli and Klebsiella pneurnon- iae in ICU patients was 56. 00% （28/50） and 70. 65% （65/92） respectively, in non-lCU patients was 52. 81% （517/979） and 40.37 % （241/597） respectively. The imipenem-resistant rate of Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, and Klebslella pneurnoniae from ICU was 36. 59%, 88.54%, 10. 00%, and 10.87% respectively, while from non-ICU was 20.21%, 6l. 15%, 1.74%, and 2.85% respectively,the resistant rates of strains from ICU were high- er than non-ICU. Conclusion Antimicrobial resistant rates of major gram-negative bacilli from ICU are higher than those from non-ICU, and the main strains are muhidrug-resistant non-fermentative bacteria. Clinical treatment should be different to reduce the emergence of drug-resistant bacteria.
出处
《中国感染控制杂志》
CAS
北大核心
2015年第7期468-471,共4页
Chinese Journal of Infection Control
基金
湖南省科技计划项目(2012SK3200)
关键词
重症监护病室
普通病房
革兰阴性杆菌
抗药性
微生物
病原菌
intensive care unit
general ward
gram-negative bacillus
drug resistance, microbial
pathogen
