摘要
目的监测重症监护病房(ICU)感染病原菌的分布及耐药情况,为临床用药及感染管理提供参考。方法对我院2007年1月1日～12月31日ICU送检的各类标本中分离出的病原菌应用法国生物梅里埃公司全自动微生物分析仪VITEK32及配套试剂进行细菌鉴别、药敏试验和产酶菌检测。结果共分离致病菌589株,其中G+球菌238株(占40.4%),前3位依次是金黄色葡萄球菌、凝固酶阴性葡萄球菌和肠球菌;G-杆菌300株(占50.9%),G-杆菌中以非发酵菌为主,占总阳性菌株的37.5%,前3位依次是铜绿假单胞菌、鲍曼氏不动杆菌、嗜麦芽窄食单胞菌;真菌92株(占15.6%)。甲氧西林耐药菌株分别占黄色葡萄球菌和凝固酶阴性葡萄球菌的92.4%和98.1%。铜绿假单胞菌对药敏谱上除头孢他啶、哌拉西林/他唑巴坦、美罗培南、亚胺培南外的所有抗生素的耐药率均超过50%;鲍曼氏不动杆菌对美罗培南、亚胺培南、哌拉西林/他唑巴坦的耐药率低于40%,余药敏谱上抗生素的耐药率均高于70%;嗜麦芽窄食单胞菌对米诺环素、头孢他啶、头孢唑啉、复方新诺明、左旋氧氟沙星的耐药率低于35%;大肠埃希氏菌和肺炎克雷伯氏菌ESBLs的检出率分别为70.6%和32.0%。结论ICU感染病原菌多重耐药现象严重,细菌耐药性监测对指导临床经验性选药及抗菌药物管理具有重要意义。
Objective To investigate the bacterial distribution and antimicrobial resistance of pathogens isolated from Intensive Care Unit （ICU） in our hospital from January 1,2008 to December 31, 2008 so as to assist clinical use of antibacterials and provide objective material in administration of antibact-erials. Methods Identification and susceptibility of pathogens were performed by VITEK32. Results Totally 589 organisms were isolated,which included 238 （40.4%） Gram-positive strains, 300 （50.9%） Gram-negative strains and 92 （15.6%） fungal strains. The rank order of Gram-positive strains was Staphylococcus aureus （20.0 % ）, coagul ase- negative Staphylococcus（CNS, 9.0 % ） and enterococci（3.2%）. Non-fermenting gram-negative rods （NFGNR） were 221 strains out of 589 isolates （37.5%）. The top three of gram-negative rods were Pseudomonas aeruginosa, Acinetobacter baummannii and Pseudomonas maltophilia. 92.4 % and 98.1% of Staphylococcus aureus and CNS were metieillin--resistant, respectively. The resistant rates of Pseudomonas aeruginosa to all abtibiotics tested were higher than 50%, except ceftazidime, piperacillin-tazobactam, imipenem, meropenem. The resistant rates of cinetobacter baummannii to various abtibiotics were higher than 70%, except imipenem, meropenem, piperacillin-tazobactam. The resistant rates of Pseudomonas maltopbilia to minocycline, ceftazidime, cefazolin and trimethoprim--sulfamethoxazolc and levofloxacin were less than 35%. ESBLs positive rates of Ecoli and Klebsiella pneumoniae were 70.6% and 32.0%, respectively. Conclusions The bacterial resistance in ICU is severe, and surveillance will be helpful for physicians to empirically use of antibacterials and for administration of antibacterials.
出处
《齐齐哈尔医学院学报》
2009年第12期1422-1425,共4页
Journal of Qiqihar Medical University
