摘要
目的分析重症监护病房(ICU)下呼吸道感染患者相关标本送检及病原菌耐药性,为临床控制医院感染提供参考。方法对ICU 2013年1-12月402例下呼吸道感染患者进行标本留取及病原菌耐药性分析,细菌培养及分离的方法依据《全国临床检验操作规程》,细菌鉴定和药敏试验采用自动化细菌鉴定及药敏分析仪VITEK-2Compact和walkaway 96进行,使用WHONET5.6软件进行耐药率统计,使用SPSS13.0软件进行统计分析。结果 402例下呼吸道感染患者痰液标本送检共1 161份,其中997份标本合格,合格率为85.87%,359份标本培养阳性,阳性率36.00%;感染患者均进行血培养,培养阳性70例,阳性率17.41%;感染患者送检胸水标本64份,培养阳性20份,阳性率31.25%;感染患者痰液标本分离出病原菌256株,血培养分离出病原菌70株,胸水培养分离出病原菌20株,分离的病原菌以鲍氏不动杆菌、铜绿假单胞菌和肺炎克雷伯菌为主;痰液中分离的鲍氏不动杆菌对头孢曲松、头孢噻肟、头孢他啶、阿米卡星和磺胺甲噁唑/甲氧苄啶的耐药率,均高于血液中分离的鲍氏不动菌耐药率。结论对于下呼吸道感染患者,在提高痰标本送检合格率的基础上,增加血液、胸水等无菌体液的送检;应正确严格的执行医院感染控制措施,遏制耐药菌在医院内的传播。
OBJECTIVE To analyze the inspected samples from patients with low respiratory tract infections in ICU so as to provide references for clinical control of hospital infections .METHODS Inspected samples from 402 pa‐tients with low respiratory tract infections in ICU from Jan .to Dec .2013 were collected and the pathogenic drug resistance analysis was conducted .＆quot;The National Clinical Test Regulation of Operation＆quot;was adopted to guide the bacteria culture and isolation .Bacterial identification and drug sensitivity testing were performed by full automatic bacteria identifier ,VITEK‐2 compact and walkaway 96 .The drug resistance rate were counted by WHONET 5 .6 and statistically analyzed by SPSS 13 .0 .RESULTS Totally 1161 samples isolated from the 402 cases were inspec‐ted .Among them ,997 samples were qualified and the rate was 85 .87% .A total of 359 samples were found to be positive and the rate was 36 .00% .All patients were treated with blood culture .The results showed that 70 cases were found to be positive in blood culture and the positive rate was 17 .41% .All together 64 hydrothorax fluid samples were inspected and the results turned to have 20 positive samples and the positive rate was 31 .25% .In the sputum samples ,totally 256 strains of pathogens were isolated .There were 70 strains isolated from blood cul‐ture ,20 from hydrothorax fluid .Acinetobacter baumannii ,Pseudomonas aeruginosa and Klebsiella pneumoniae dominated the majority of all isolated pathogens .A .baumannii from the sputum samples were more resistant to ceftriaxone , cefotaxime , ceftazidime , amikacin and sulfamethoxazole/trimethoprim than other origins . CONCLUSION For patients with low respiratory tract infections ,inspection of blood and pleural fluid samples should be added except inspecting sputum samples .Correct and strict control measures should be carried out to restrain the spread of pathogens .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第19期4406-4408,共3页
Chinese Journal of Nosocomiology
基金
美国CMB基金资助项目(09-977)
关键词
重症监护病房
下呼吸道感染
标本留取
病原菌
耐药性
ICU
Low respiratory tract infections
Sample collection
Pathogens
Drug resistance rate
