摘要
目的 了解ICU耐碳青霉烯类铜绿假单胞菌感染患者的耐药情况,并作出分析,为临床预防及治疗提供可靠依据。方法 收集2010年1月~2012年12月ICU经细菌培养鉴定为铜绿假单胞菌菌株126株,采用ATB微生物半自动鉴定系统进行细菌鉴定,用Kirby-Bauer纸片扩散法进行药物敏感性试验。将铜绿假单胞菌感染患者78例经药敏试验分为耐碳青霉烯类患者组和非耐药组,对两组患者的病死率、入住ICU天数及带呼吸机天数进行分析。结果 从痰液中分离出的铜绿假单胞菌菌株占首位,为57.14%,其余依次为引流液21.43%,血液15.08%,导管尖端3.17%,穿刺液和伤口分泌物均是1.59%;铜绿假单胞菌对亚胺培南、美罗培南的耐药率分别是31.45%和25.29%;与非耐药组比较,耐药组患者的预后差、病死率高,达到78.57%（P〈0.05）;患者入住ICU天数延长和带天数均较非耐药组有显著差异（P〈0.05）。结论 ICU中耐青霉烯类铜绿假单胞菌感染患者耐药情况严重,病死率高,预后差。临床治疗中要合理使用抗菌药物,加强细菌耐药的监测。
Objective To understand and analyze the prognosis of patients infected by carbapenem - resistant Pseud- omonas aeruginosa （PA） in ICU so as to provide a reliable basis for clinical treatment. Methods A total of 126 strains of PA were identified an their source distribution was analyzed. These strains were derived from bacterial cultures collected in ICU of my hospital between Jan 2010 and Dee 2012 ; the identification of bacteria was completed by using ATB microbial identification system of semi automatic. The drug susceptibility testing was carried out using Kirby - Bauer method; 78 patients infected by PA were divided into carbapenem - resistant patient group and non - carbapenem - resistant patient group. For both groups, the fatality rate, ICU staying and the duration of using of ventilator were ana- lyzed. Results The PA strains derived from the sputum were the predominant, accounting for 57. 14% of the total num- ber, followed by the drainage fluid （21.43 % ）, blood （ 15.08% ）, the tip of catheter （3.17%）, puncture fluid and wound secretion were the same（ 1.59% ）. The resistant rates of PA to imipenem and meropenem were 31.45% and 25.29% respectively. As compared with the non carbapenem - resistant patient group, the prognosis of the patients with PA infection was poor and the fatality rate was high, reaching up to 78.57% ; the difference was statistically significant （ P 〈 0. 05 ）, the duration of ICU staying and using of ventilator were extended, the difference was statistically significant （P 〈 0. 05）. Conclusions For patients infected by PA in ICU, the bacterial resistance is serious, the fatality rate is high , the prognosis is poor. We must use antimicrobial drugs reasonably and monitor bacterial resistance vigorously in Clinical treatment.
出处
《航空航天医学杂志》
2014年第9期1194-1195,共2页
Journal of Aerospace medicine
关键词
耐药性
铜绿假单胞菌
碳青霉烯类
预后
Bacterial resistance
Pseudomonas aeruginosa
Carbapenems
Prognosis
