摘要
目的 探讨重症监护病房 (ICU)下呼吸道感染的病原学分布及耐药性特征。方法 对我院ICU 2 0 0 1年 1月至 2 0 0 3年 6月下呼吸道感染的 79例患者痰培养的 2 12株病原菌和药敏结果进行分析。结果 检出 2 12株细菌中革兰阴性杆菌占 80 .2 % ,革兰阳性球菌占 19.8%。以阴沟肠杆菌和金黄色葡萄球菌分别居革兰阴性杆菌和革兰阳性球菌的首位 ,不动杆菌和粪肠球菌的感染率有上升趋势。MRSA(耐甲氧西林金黄色葡萄球菌 )比例升高 ,仅对万古霉素和头孢他啶耐药性低。革兰阴性杆菌对头孢哌酮 舒巴坦、亚胺培南和丁胺卡那敏感性较高。结论 ICU下呼吸道感染病原菌以革兰阴性杆菌为主 ,感染菌耐药性高 ,尤以ESBLs( +) (产超广谱B内酰胺酶 )明显 ,不动杆菌已逐渐成为ICU下呼吸道感染的优势菌群。控制第二、三代头孢菌素以及制酸剂 (质子泵抑制剂 )的预防性用药 ,减少耐药菌株的产生 。
Objective To investigate the distribution of the pathogens and their drug resistance in patients with lower respiratory tract infection in ICU (intensive care unit).Methods An analysis was made about 212 strains of sputum culture from 79 patients with lower respiratory tract infection in ICU and drug susceptibility test from 2001.1～2003.6.Results Among 212 clinical isolates,Gram-negative bacteria accounted for 80.9%,Gram-positive bacteria accounted for 19.8%.The e.cloacae and s.Aureus were the main strains of Gram-negative bacteria and Gram-positive bacteria respectively,the infection rate of Acinetobacter and E.fecalis had the rising tendency.The rate of MRSA (methicilin resistant staphylococcus aureus) increased,which was lower resistant only to vancomycin and ceftazidime.Gram-negative bacteria were still sensitive to cefoperaxone/sulbactam,imipenem and amikacin.Conclusion Gram-negative bacteria are main strains of lower respiratory tract infection in ICU,the drug resistance of infective pathogens is high,especially the becteria who produce extended-spectrum beta-lactamases (ESBLs).Acinetobater is becoming the most common bacteria infection in ICU.To control the prophylactic cephalothin and antacid (proton pump inhibitor),reduce the production of resistive bacteria and resonably use antibiotics is the effective measure for the treatment of lower respiratory tract infections.
出处
《河北医药》
CAS
2004年第10期775-776,共2页
Hebei Medical Journal
