摘要
目的调查分析ICU导尿管相关性尿路感染(CAUTIs)致病菌的分布及耐药性,为医院感染管理及合理用药提供依据。方法收集2010年1月-2013年10月ICU留置导尿患者的尿液标本792份,对送检标本进行细菌培养和药敏试验,统计病原菌分布及其耐药性,采用ATB-Expression微生物鉴定仪鉴定细菌,用ATB-Expression配套的药敏系统进行药敏试验。结果 792份送检标本共分离病原菌155株,其中真菌占41.9%,革兰阳性球菌占32.9%,革兰阴性杆菌占25.2%;肠杆菌科细菌中产ESBLs株分离率为68.3%,对碳青霉烯类药物保持较高的敏感性,检出耐亚胺培南大肠埃希菌和阴沟肠杆菌各1株;屎肠球菌的耐药率高于粪肠球菌,两者对万古霉素的敏感率均为100.0%;白色假丝酵母菌对抗真菌药物的敏感率高于非白色假丝酵母菌。结论 ICU是医院感染管理的重点,提高护理服务质量、合理使用抗菌药物、减少导尿管留置时间对预防和控制导尿管相关性尿路感染有积极意义。
OBJECTIVE To investigate the distribution and drug resistance of the pathogenic bacteria causing cathe-ter-associated urinary tract infections （CAUTIs）in the ICU so as to provide guidance for the control of nosocomial infections and the reasonable use of antibiotics.METHODS Totally 792 urine specimens were collected from the pa-tients who underwent the catheter indwelling in the ICU from Jan 2010 to Oct 2013,then the submitted specimens were cultured,the drug susceptibility testing was performed,the distribution and drug resistance of the pathogens were statistically analyzed,the bacterial identification was carried out by using ATB-Expression microorganism identification system,and the drug susceptibility testing was performed with the use of matched ATB-Expression drug susceptibility system.RESULTS A total of 155 strains of pathogens have been isolated from the 792 submitted specimens,including the fungi （41.9%）,the gram-positive cocci （32.9%）,and the gram-negative bacilli （25.2%）.Among the isolated Enterobacteriaceae,the isolation rate of the ESBLs-producing strains was 68.3%, and the strains remained highly susceptible to carbapenems;1 strain of imipenem-resistant Escherichia coli and 1 strain of imipenem-resistant Enterobacter cloacae were also isolated.The drug resistance rate of the Enterococcus feces was higher than that of the Enterococcus faecalis,and the drug susceptibility rates of the both species to vancomycin were 100.0%;the drug susceptibility rate of the Candida albicans to antifungal agents was higher than that of the non-C.albicans strains.CONCLUSION It is of positive significance for the prevention and control of catheter-associated urinary tract infections to focus on the control of nosocomial infections in the ICU,improve the quality of nursing service,reasonably use antibiotics,and shorten the catheter indwelling time.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第1期64-66,共3页
Chinese Journal of Nosocomiology
基金
浙江省自然科学基金资助项目(LYl3H200004)
关键词
重症监护病房
导尿管相关性感染
培养结果
调查分析
Intensive care unit
Catheter-associated infection
Result of culture
Investigation and analysis
