摘要
目的探讨器官移植ICU院内感染病原菌的分布及其耐药性。方法回顾性分析2012年6月至2015年9月中山大学附属第三医院岭南医院器官移植ICU内确诊为院内感染的104例患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男87例,女17例,平均年龄(43±11)岁。观察器官移植ICU院内感染的病原菌构成比、标本来源分布,并进行耐药性分析。结果 104例患者中共分离出感染病原菌136株。其中革兰阴性菌最多,占61.8%(84/136);其次为真菌,占35.6%(37/136);革兰阳性菌占11.0%(15/136)。病原菌标本主要来源于痰标本。革兰阴性菌中鲍曼不动杆菌呈现多重耐药或泛耐药趋势,对抗生素耐药率普遍较高;非鲍曼不动杆菌的耐药率较鲍曼不动杆菌低,对碳青霉烯类药物的敏感性仍较好。真菌对常用的抗真菌药物均有不同程度耐药,但对氟胞嘧啶、两性霉素B敏感性较好。革兰阳性菌抗生素耐药较严重,但尚未发现对万古霉素及利奈唑胺耐药。结论器官移植ICU的院内感染病原菌主要为革兰阴性菌,其次为真菌、革兰阳性菌。革兰阴性菌中鲍曼不动杆菌呈现多重耐药或泛耐药趋势,非鲍曼不动杆菌对碳青霉烯类药物的敏感性仍较好;真菌对常用的抗真菌药物均有不同程度耐药;革兰阳性菌对万古霉素及利奈唑胺敏感。
Objective To investigate the distribution and drug resistance of pathogens causing nosocomial infection in organ transplantation ICU. Methods Clinical data of 104 patients with nosocomial infection in organ transplantation ICU of Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University from June 2012 to September 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 87 males and 17 females with a mean age of （43±11） years old. The composition ratio of pathogens and the distribution of specimen sources in organ transplantation ICU were observed and the drug resistance was analyzed. Results A total of 136 pathogens were isolated from 104 patients, including 61.8% （84/136） of gram-negative pathogens, 35.6%（37/136） of fungi followed by 11.0% （15/136） of gram-positive pathogens. The pathogenic specimens were mainly derived from sputum samples. As a kind of gram-negative pathogens, Acinetobacter baumannii was observed with a tendency of multi-drug resistance or extensive drug resistance and was highly resistant to antibiotics. Non-Acinetobacter baumannii was observed with less drug resistance than Acinetobacter baumannii. It was sensitive to carbapenems. The fungi exhibited varying degree of resistance to commonly used antifungal drugs, whereas was sensitive to fucytosine and amphotericin B. Gram-positive pathogens were observed with high resistance to antibiotics but yet to vancomycin and linezolid. Conclusions Gram-negative pathogens are the primary pathogens causing nosocomial infection in organ transplantation ICU, followed by fungi and gram-positive pathogens. As a kind of gram-negative pathogens, Acinetobacter baumannii reveals a tendency of multi-drug resistance or extensive drug resistance. Non-Acinetobacter baumannii is sensitive to carbapenems. Fungi exhibits varying degree of resistance to commonly used antifungal drugs. Gram-positive pathogens are sensitive to vancomycin
出处
《中华肝脏外科手术学电子杂志》
CAS
2017年第1期54-58,共5页
Chinese Journal of Hepatic Surgery(Electronic Edition)
基金
广东省自然科学基金面上项目(S2013010016785)
关键词
器官移植
重症监护
交叉感染
抗药性
Organ transplantation
Intensive care
Cross infection
Drug resistance
