摘要
目的:了解南京医科大学第一附属医院2007年ICU病原菌分布及细菌耐药情况,为临床防治提供依据。方法:采用API鉴定系统鉴定细菌及真菌;纸片扩散法测定细菌药物敏感性,Rosco纸片法测定真菌药物敏感性;WHONET5.4软件进行统计分析。结果:2007年该院总标本数为4431份,ICU标本数为343份,阳性率为7.7%,病原菌以G-为主,占70.7%,其中非发酵菌占46.9%,肠杆菌科细菌占23.8%。非发酵菌以铜绿假单胞菌(37.3%)和不动杆菌(7.6%)多见,肠杆菌科细菌以克雷伯菌(10.5%)、大肠埃希菌(6.1%)为多;G+菌以金黄色葡萄球菌(金葡菌)为主。从耐药性分析来看,葡萄球菌属未发现万古霉素耐药株,但对其他多种抗菌药物耐药;肠杆菌科细菌对亚胺培南、美洛培南、头孢哌酮/舒巴坦和阿米卡星较敏感;非发酵菌中,铜绿假单胞菌对大部分抗菌药物耐药,而不动杆菌则对美洛培南、亚胺培南和头孢哌酮/舒巴坦较敏感。结论:该院ICU感染病原菌对多种抗菌药物耐药率较高,应合理选择抗菌药物。
Objective：To analyze the pathogen distribution and resistance in ICU of our hospital so as to provide the evidence for treatment. Methods：The bacteria and fungi were identified by API system; the sensitivity of antimierobial agents and antifungal agents was tested by K-B and Rosco disk diffusion method; the data was analyzed by WHONET 5.4. Results：In 2007,there were 3341 specimens in our hospital including 343 specimens in ICU, and the positive rate of specimens was 7.7%. Gram-negative bacteria （70.7%） was the mains in ICU. Among the total, the rate of Nonfermenters was 46.9% and Enterobacteriaceae was 23.8%. Most of Nonfermenters were P. aerug/nosa（37.3%） and Acinetobacter（7.6%）. The majority of Gram-positive bacteria were Staphylococcus aureus. In view of the resistance, Staphylococcus species resistant to Vancomycin, while they were resistant to many other antimicrebial a- gents. Gram-negative Enterobacteriaceae were fairly sensitive to carbapenems, cefoperazone/sulbactam and piperacillin/tazohactam. Among nonferrnenters, P. oeruginosa were resistant to the most antimicrobial agents while Acinetobacter were comparatively sensitive to carbapenems and cefoperazone/sulbactam. Conclusion：The pathogens in ICU have a high resistant rate to many antimicrobial agents. In view of the seriousness of this problem, we must lay enough emphasis on it and select antimicrobial agents rational.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2009年第2期267-271,共5页
Journal of Nanjing Medical University(Natural Sciences)
