摘要
目的了解上海儿童医学中心重症监护病房(ICU)感染患儿临床分离细菌的种类及其对各种常见抗菌药物的敏感性,为临床合理应用抗菌药物提供参考依据。方法采用VITEK 2全自动微生物分析系统鉴定临床分离菌株,体外药物敏感性试验采用E-test法、纸片扩散法和自动仪器法,参照2014版美国临床实验室标准化协会(CLSI)标准判断药物敏感性试验结果。抗菌药物敏感性分析采用WHONET 5.6软件。结果2012年1月至2014年12月共收集ICU患儿首次分离细菌5 133株。检出病原菌居前3位的样本分别为呼吸道(66.8%)、血液(15.2%)、尿液(11.8%);主要病原菌分别为肺炎克雷伯菌(16.9%)、凝固酶阴性葡萄球菌(15.0%)、大肠埃希菌(14.5%)、鲍曼不动杆菌(12.7%)和金黄色葡萄球菌(10.1%)。多重耐药菌监测中以产超广谱β-内酰胺酶肠杆菌科细菌为主(61.0%);耐碳青霉烯类抗菌药物鲍曼不动杆菌和耐碳青霉烯类抗菌药物肠杆菌科细菌均有上升趋势。结论 ICU感染患儿分离的细菌其耐药性问题比较严重,应引起关注。
Objective To investigate the kinds and antibiotic susceptibility of isolates in intensive care unit（ICU）of Shanghai Children′s Medical Center. Methods VITEK 2 automatic microbial analysis system was used to identify isolates, and antibiotic susceptibility was determined by E-test,Kirby-Bauer（K-B） method and automatic systems. The data were analyzed by WHONET 5.6 software,according to the document of the Clinical and Laboratory Standards Institute（CLSI）2014. Results A total of 5 133 non-duplicate isolates were collected in ICU from January 2012 to December 2014. The isolates were mainly isolated from respiratory tract samples（66.8%）,blood（15.2%）and urine（11.8%）. The primary microorganisms were Klebsiella pneumoniae（16.9%）,coagulase-negative Staphylococcus（15.0%）,Escherichia coli（14.5%）,Acinetobacter baumannii（12.7%）and Staphylococcus aureus（10.1%）. The primary microorganisms of multidrug-resistant isolate was extended-spectrum beta-lactamasesproducing Enterobacteriaceae（61.0%）,and carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Enterobacteriaceae had an increasing tendency. Conclusions The drug resistance of isolates is high in ICU,which should be paid more attention.
出处
《检验医学》
CAS
2016年第4期258-265,共8页
Laboratory Medicine
关键词
细菌耐药性
重症监护病房
抗菌药物
Drug resistance
Intensive care unit
Antimicrobial agents
