摘要
目的了解重症监护病房(intensive care unit,ICU)患者感染病原菌分布及耐药情况,为临床合理用药提供理论依据.方法收集2007年1月至2009年12月我院ICU病房送检标本检出的病原菌,采用美国MicroScan-WalkAway96SI全自动微生物分析仪进行细菌鉴定及药敏试验,WHONET 5.4软件进行数据分析.结果共分离出720株病原菌,主要分布于痰液(75.8%)和血液(7.8%).革兰阴性杆菌476株(66.1%),革兰阳性球菌175株(24.3%),真菌69株(9.6%).前5位病原菌为铜绿假单胞菌122株(16.9%)、鲍曼不动杆菌87株(12.1%)、金黄色葡萄球菌82株(11.4%)、凝固酶阴性葡萄球菌62株(8.6%)、肺炎克雷伯菌61株(8.5%).主要革兰阳性球菌对青霉素、红霉素等有较高的耐药率,均大于60.0%,未发现对万古霉素耐药的菌株.大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶的检出率分别为46.2%和37.7%,对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿米卡星的耐药率均低于25.0%.亚胺培南对除嗜麦芽寡氧单胞菌外的其他革兰阴性杆菌均具有较好的抗菌活性.结论加强ICU病房细菌耐药性的监测,对指导临床合理用药,防止耐药菌株的传播具有重要意义.
Objective To investigate the pathogen distribution and drug resistance in intensive care u nit(ICU)and provide theoretical bases of rational usage of antibiotics for the clinic.Methods The pathogen isolated from ICU samples in our hospital were collected from January 2007 to December 2009.Isolated colonies were identfied by MicroScan-WalkAway96SI and sensitivity test adopted Kirby-Bauer method.Data was analyzed by WHONET 5.4 software.Results A total of 720 strains pathogen bacteria mainly distributed in sputamentum(75.8%)and blood(7.8%),which included 476(66.1%)gram-negative strains,175(24.3%)gram-positive strains and 69(9.6%)fungal strains.Pseudomonas aeruginosa 122 strains(16.9%),A cinetobacter baumannii 87 strains(12.1%),Staphylococcus aureus 82 strains(11.4%),coagulase negative Staphylococcus 62 strains(8.6%),and Klebsiella pneumoniae 61 strains(8.5%)were the most common isolates.The drug resistance of main gram positive coccus to penicillin,erythrocin were all higher than 60.0%,while there was no strain tol erated to vancomycin.The detection rate of extended spectrum β-lactamases in Escherichic coli and Klebsiella pneumoniae were 46.2%and 37.7%respectively.The drug resistance to piperacillin/tazobactam,cefoperazone/sulbactam and amikacin were all lower than 25.0%.Imipenem showed good antimicrobial activity to gram-neg ative bacilli except Stenotrophomonas maitophillia.Conclusion Strengthen the monitoring of drug resistance in ICU has important significance for directing drug usage and preventing bacterial drug resistance from being transmitted.
作者
孙琪
郭微媛
SUN Qi;GU Wei-yuan(Department of Clinical Laboratory,the Second Affiliated Hospital of Harbin MedicalUniversity,Harbin 150086,China)
出处
《实用检验医师杂志》
2011年第3期165-167,共3页
Chinese Journal of Clinical Pathologist
关键词
重症监护病房
病原菌
耐药性
Intensive care unit
Pathogen
Drug resistance
