摘要
目的探究重症监护病房(ICU)患发肺部感染患者的病原微生物分布状况,并对其耐药性进行分析,为临床合理用药提供参考。方法将沈阳市康平县人民医院检验科从2013年10月至2016年9月ICU收治的患发肺部感染患者110例作为研究对象,分别采集患者的呼吸分泌物与痰液标本并对其给予菌株鉴定,应用纸片扩散法完成药敏试验,回顾性分析患者分离出的病原菌分布情况以及耐药性。结果 110例肺部感染患者的痰液标本中共分离出232株病原微生物,主要有75.86%的革兰阴性菌,13.79%的革兰阳性菌,10.34%的真菌;铜绿假单胞菌、鲍氏不动杆菌以及嗜麦芽寡养单胞菌三种主要革兰阴性菌对氨苄西林与氨曲南等药物的耐药性偏高,对头孢哌酮/舒巴坦的耐药性最低;32株革兰阳性菌中有93.75%的耐甲氧西林葡萄球菌;真菌检查其对氟康唑及伊曲康唑两种药物的敏感性不足90.00%,对两性霉素B、氟胞嘧啶以及伊曲康唑、伏立康唑耐药性均较低。结论 ICU患发肺部感染患者多数是多重菌株混合感染,其中革兰阴性菌、革兰阳性菌以及真菌为主要病原微生物,最多见的是革兰阴性菌,分离出的病原菌大都表现为多药耐药性,临床治疗难度较高;临床必须重视预防ICU肺部感染的发生,同时要按照药敏试验结果为患者应用最合理的抗菌药物。
Objective To investigate the distribution of pathogenic microorganism in（intensive care unit,ICU）patients with pulmonary infection,and to analysis their drug resistance,eventually to provide references for clinicians to choose rational administration.Methods A total of 110 patients with pulmonary infection from ICU,Kangping County People＇s Hospital were investigated as the subject during from October 2013 to September 2016.Respiratory secretions and sputum samples of patients were collected separately as the sample of strain identification.Disk diffusion methods was used to complete the drug sensitive test.Retrospective analysis the distribution of pathogenic bacteria and the patient’s tolerance.Results A total of 232 pathogenic microorganisms were isolated from the sputum samples of 110 patients with lung infection.Mainly consisted of 75.86%Gram-nefative bacteria,13.79%Gram-positive bacteria and 10.34%epiphyte.Three main Gram-negative bacteria（Pseudomonas aeruginosa,Acinetobacter baumannii and Stenotrophomonas maltophilia）had the high drug resistance to ampicillin and aztreonam but to Cefoperazone/sulbactam their tolerance was lowest.and 93.75%of gram-positive bacteria were methicillin-resistant staphylococcus aureus;the two kinds of fluconazole and itraconazole drug sensitivity of less than 90.00%fungal isolates examined,amphotericin B and flucytosine to itraconazole,voriconazole and drug resistance were lower.Conclusion Most of the ICU patients with pulmonary infection were multiple strains of mixed infection,and the main pathogenic microorganisms are gram-negative bacteria,gram-positive bacteria and epiphyte.The most common pathogenic microorganisms is gram-negative bacterium and most of them showed multidrug resistance so there is a high degree of difficulty in clinical treatment.Medical attention must be taken to prevent the occurrence of pulmonary infection from ICU and the most appropriate antimicrobial agents should be applied to the patient in accordance with the experimental results.
出处
《中国药物经济学》
2017年第9期133-136,共4页
China Journal of Pharmaceutical Economics
关键词
重症监护病房
肺部感染
病原微生物
耐药性
ICU
Pulmonary Infection
Pathogenic Microorganism
Drug Resistance
